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  • Managing Mental Health in the Workplace

    Managing Mental Health in the Workplace

    An average Malaysian typically spends one-third of his time a day at work notwithstanding the additional time spent on commuting to and fro from work, additional meetings, and overtime to complete projects.

    As the work environment plays a big role in shaping our experiences throughout the day, it is indeed time to start thinking about mental health initiatives in the workplace.

    As a developing country, the more organisations strive for development, the more that employees are pushed to perform, often times at the risk of their quality of life. Mental health-related issues are estimated to be experienced by at least 40% of the Malaysian population in their lifespan.

    The statistics mean that employers are now hard-pressed to acknowledge the burden of cost that mental illness can bring to their organisation and actively work to curb it.

    mental health

    To do that, organisations first need to understand the difference between mental health and mental illness. Simply put, mental health is a state of well-being where an individual is able to cope with common stressors in life, work productively and realize his or her potential and contribute back to the community.

    It is not just an absence of mental illness such as depression, anxiety, schizophrenia or so on and forth. Mental health occurs in a spectrum where wellbeing and disability are two opposing ends. The goal is then to increase practices that promote mental health and reduce those that hinder it.

    The relationship between work and mental health can’t be studied in isolation and has to be seen in the larger context of one’s life. For example, staying back late may be a norm that is perceived as a commitment to the organisation, which then influences promotion, perks and benefits.

    However, routinely staying back to complete work may be a sign of a lack of time management and an over-prioritisation of work. This then causes other aspects of one’s life, such as health, family, spiritual needs, and social life, to take a back seat and to be ignored or given less priority.

    mental health

    The cumulative effect of constantly neglecting these other aspects then creeps back into a person’s life in the form of health issues, relationship troubles, unhappy marriages, the feeling of leading a meaningless life and more, which then gnaws on the ability of one to be completely productive at work.

    Read : Buying A Car? Here’s Some Tips On How Best To Finance A Car

    Workplaces can help prevent this by changing their work cultures to be more balanced. Organisations are predominantly made of people and people have the potential to shape workplace cultures. This starts with cultivating the awareness that every aspect of life is important and needs to be paid attention to; for top management rights to the interns.

    Firstly, it is important to realize that everyone has only 24 hours a day, though we often wish we had more. As such, a conscious prioritisation of activities that enables one to fulfil their different needs is important.

    Workplaces can help by creating a healthy work-life balance by ensuring proper break times; reducing work-related communication during the weekend and after-work hours, avoiding lengthy meetings and ensure that time at work is efficiently used to achieve goals.

    Human resource policies can also reflect the priority of the organisation with regard to employees’ mental health. The rise of millennials in the workforce, for instance, creates a highly tech-savvy cohort at work that may prefer flexi-working hours that prioritizes output instead of physical presence in the office.

    mental health

    Organisations can maximize productivity by constantly studying new trends and catering to them. Gamification (the application of concept, skills and design of games and implementation in the workplace) efforts that can maximize output in a fun, engaging and mutually reinforcing way is one example of such trends.

    Open, honest and most importantly respectful communication within an organisation sets the tone for the relationships at work as well. The general workplace impression is that “everyone is replaceable.”

    However, when organisations create an idea that everyone is included in the team for their unique skillset and is valuable to the team, it changes the tone of the work environment.

    Another thing to consider while discussing wellness at work is that there could be many external stressors that are unrelated to work that could affect a person’s commitment. Caring for elderly parents, sick children, school meetings, accidents, chronic illnesses to name a few, are some of the stressors that employees may face over the course of their employment.

    When employers are sensitive to these needs that may crop up, sometimes unplanned and uncalled for, the way they respond to the employee can be a gauge of how much they care about the employee as a person.

    Finally, it is imperative to note that mental health at the workplace does not only apply to the wage earners but every stakeholder in the workplace. When top management understands the need to care for their own mental health, it brings about change in policies, formal and informal practices, and the overall work culture, which influences the employees as well.

    About the Author

    Puveshini Rao (M. Clin Psych) is a Clinical Psychologist and Employee Assistance Program specialist currently practicing in Rekindle Sdn. Bhd. She is a HRDF certified trainer and currently conducts trainings and provides EAP services for organisations while also seeing clients with mental health related issues. Previously she has experience providing counselling services in the university and hospital settings. She is also on the committee of Women’s Aid Organisation and volunteers her time to the cause.

  • Can You Be Athletic And A Vegetarian?

    Can You Be Athletic And A Vegetarian?

    A vegetarian diet excludes meat, poultry, and fish; some people also omit eggs and dairy products, while vegans exclude animal products altogether.

    You can take it a step further by going on a raw or gluten-free diet. Besides the obvious, which is that any diet built on exclusions is emotionally hard, a vegetarian diet can be a challenge when it comes to your nutrient intake and energy levels.

    On the plus side, however, a vegetarian diet usually involves a higher intake of antioxidants and phytonutrients which reduce free radical damage during intense exercise.

    Nutrient Concerns

    nutrients athletic and a vegetarian

    Protein also acts as a complement to carbs. They help regulate the rate at which carbs enter your bloodstream and prevent sugar spikes and crashes. In addition, strength athletes need protein to build muscle mass. A plant-based diet is also usually high in fibre which further inhibits protein absorption.

    Vegetarian diets are also generally low in B12, iron, and calcium. These are particularly important for endurance athletes as B12 helps produce red blood cells and prevents you from becoming anaemic. It’s also important for nerve and mental health – long-term deficiency can lead to cognitive impairment, while lack of iron and calcium can affect your immunity and bone health respectively.

    Salt and fats seem like bad things to want to put into your body as an athlete, but they are essential to your overall wellbeing. Poorly planned vegetarian diets lack both. Fats help your body absorb fat-soluble vitamins like A, D, E, and K and regulate carb absorption so that your sugar levels stay consistent.

    KFit Asia head of operations Shakira Shanaz, who is currently on a vegetarian diet as part of her yoga teacher training course, agrees. “My body craved more sugar, so I’d make myself Milo when I would usually just have water.” Low sodium levels, on the other hand, can lead to muscle cramps, especially if you are sweating a lot.

    So, can you still be athletic and a vegetarian?

    Read : What Happens To Your Body When You Stop Exercising?

    Supplementing A Vegetarian Diet

    athletic and a vegetarian

    Adequate protein intake on a plant-based diet is difficult but possible with proper planning. Opt for protein rich foods like beans, lentils, legumes, nuts, and seeds. Quinoa and soy are great protein solutions too, as they are complete sources of protein―tempeh is a firm favourite.

    It is important to remember that you will need to eat larger portions for the same amount of protein you would get from meat, and a handful of nuts in your salad is not going to cut it.

    Read: How To Manage Your Quarter Life Crisis?

    Increase iron absorption with the aid of vitamin C rich fruits and vegetables. B12 is not readily available in non-meat items but you can opt for fortified cereals or supplements. Give your body the good fats it needs with avocado, olive oil, or flaxseed oil.

    Avoid fibre-heavy meals right before a workout so that you have plenty of time to digest. You should also include a post-workout protein meal to help with muscle synthesis. Protein shakes are useful here too.

    Meals don’t need to be boring! You can also substitute your usual flour with soy protein powder or bean flour. Peanut butter is a great source of nutrients for vegetarians as well.

    Don’t forget to salt your food (within reason)!

    Yes or No?

    There are marginal benefits to being an athlete on a vegetarian diet. Over time you tend to feel less bloated and have a quicker recovery time, plus you will probably have a lower intake of bad fats and cholesterol.

    However, D. Enette Larson-Meyer, associate professor of human nutrition at the University of Wyoming, has a different opinion.

    Many people tell me after they start a vegetarian diet that they feel better, but then again many of them… were eating a pretty poor diet, so of course they feel better. They could have switched to a healthier meat-based diet and they would have probably felt better.

    Shakira concurs. “I mostly self-prepare my food as eating out while vegetarian is expensive. I also avoid greasy food since I’m already making an effort to be healthy. I feel like this, more than the vegetarian diet, contributed to my feeling lighter and less lethargic.

    “Would I continue to be a vegetarian once my course is over? Probably not. I will eat cleaner and healthier, but I don’t think being a vegetarian is necessary for health.”

    Still, there is no harm being an athlete on a vegetarian diet if you choose to do so. It requires greater care and planning than a meat-based diet to ensure you are getting all the nutrients you need, but it’s not impossible.

  • What Happens To Your Body When You Stop Exercising?

    What Happens To Your Body When You Stop Exercising?

    Exercise encourages your brain to work at optimum capacity by causing your nerve cells to multiply, strengthening their interconnections, and protecting them from damage. There are multiple mechanisms at play here, but some are becoming more understood than others.

    The rejuvenating role of brain-derived neurotrophic factor (BDNF) is one of them. BDNF activates brain stem cells to convert into new neurons. It also triggers numerous other chemicals that promote neural health.

    Promote Intelligence And Better Mood With Just 20 Minutes A Day

    A number of neurotransmitters, such as endorphins, serotonin, dopamine, glutamate, and GABA, are also triggered by exercise. Some of these are well known for their role in mood control. Exercise, in fact, is one of the most effective prevention and treatment strategies for depression.

    BDNF and endorphins are two of the primary factors triggered by exercise that help boost your mood, make you feel good, and sharpen your cognition. So, how much do you have to exercise in order to maintain a sunnier disposition and better memory long-term?

    According to a 2012 study published in the journal Neuroscience, the ‘secret’ to increased productivity and happiness on any given day is a long-term investment in regular exercise. And a little each day appears to go further than a lot once or twice a week.

    Here’s What Happens When You Stop Exercising

    You probably expect that your muscle tone will take a beating once your workouts stop, but less expected changes will occur throughout your body. One of the first places to experience the repercussions may actually be your brain.

    Research published in the journal Frontier in Aging Neuroscience revealed that endurance runners who skipped exercise for 10 days had reductions in blood flow to their brain’s hippocampus, which is a region associated with memories and emotions.

    After about two weeks, meanwhile, your endurance may suffer, which means you may find yourself slightly more winded if you need to quickly climb a few flights of stairs. This is because of changes to your VO2 max (also known as maximal oxygen intake).

    VO2 max is defined as the maximum volume of oxygen you can utilise in one minute of maximal or exhaustive exercise, and it’s used as a measure of endurance.

    If your workouts take an even longer hiatus, you can expect increasingly noticeable changes to your body, both physically and aesthetically. You may start to notice your strength slipping after about two or four weeks with no activity. And after about six to eight weeks, you may start to gain weight.

    There Are Times When You Should Skip A Workout

    Skipping workouts generally isn’t recommended – unless you have one of these five valid reasons for not working out.

    You’re sick – If you have a slight cold and you’re not overly tired, a quick workout can be beneficial in that it raises your body temperature and might help to fight off viruses;

    You’re injured – Regular exercise can help you to prevent many injuries, however you’ll want to avoid exercising an injured area of your body. If you have a shoulder injury, you may still be able to work out your lower body (or vice versa), so long as you don’t aggravate the injured area. Avoid activities that cause pain and, if the injury is going to take a long time to heal, work with a physical therapist who can provide you with a safe exercise plan that promotes healing;

    You’re exhausted – If you’ve had a poor night’s sleep, you may be better off sleeping in than getting up early for your morning workout. Like exercise, sleep is also essential for your health, and you generally don’t want to sacrifice one for the other. It’s difficult to catch up on sleep once you’re sleep-deprived, so make sleep a top priority. This isn’t an excuse to hit your snooze button daily, however;

    You overdid it and you’re extremely sore – Delayed onset muscle soreness (DOMS), or the muscle soreness you’ve experienced one to two days after exercise, is caused by inflammation stemming from microscopic tears in your muscle fibres. DOMS is normal and is not typically a sign that you should skip a workout; or

    You’re having a marathon day – We all have those days when our schedules are jam-packed. Trying to fit in a long workout on such a day may not be in the cards. It’s OK to skip your workout when you get too busy – once in a while. However, resist using this all-too-common excuse to not exercise too often. The truth is, most of us are quite busy, so you need to make exercise a priority.

    Regular workouts will help you to stay focused, think clearer and get sick less often. So, what’s not to like? It does take time, commitment and hard work, which is why the exercise programmes that last will be those you find most enjoyable. The key word is ‘enjoy’.

    The more you look forward to your workouts, the more likely you are to keep doing them. As an added bonus, most people feel great after they workout, which provides additional motivation to keep going. If you don’t feel good after your work out – for instance you feel exhausted instead of energised – this is a sign that you may be exercising too much and need to take more time for recovery.

    About the Author

    This article was brought to you by Dr Mercola, a New York Times bestselling author. For more helpful articles, please visit Mercola.com

  • Understanding What We Can Control Will Help Boost Our Health

    Understanding What We Can Control Will Help Boost Our Health

    The past few years saw many unprecedented events, including a sudden change of government and a total shift in how we work, live, and interact with each other. Some have helplessly seen their rice bowls snatched away, while others have suffered losses of loved ones to Covid-19.

    Coupled with volatile stock markets, movement control orders, elections and re-elections, and working from home, it is safe to say that no one quite anticipated a year like this. While we are not sure when Covid-19 will be defeated, the one certainty is that if we are so wrapped up in our problems, we may be overlooking things in our life that we can control.

    Here are three areas where you can take some purposeful steps to remind of who is ultimately in charge of your family’s “Return on Life”:  

    1. Your Mental Health

    Diseases and health threats are nothing new, with people passing away daily even before Covid-19. The difference this time is it made us realise that none of us can control how long we have when it comes to life. In addition to very real health concerns this year, there has also been plenty of news of job cuts and losses, people going through financial struggles and more. 

    As we fight to keep hope, the news can be demoralising. With many spending more time on social media, it actually exposes us to news that may magnify our anxiety and bounces them back to us over and over again. 

    If you’re not working or checking on your friends, set some daily screen time limits. Unplugging before bed can be especially beneficial if your brain is still recovering from a full day of tweets and likes. Our electronic devices and apps are designed to attract our attention. When it’s time to sleep, there’s no better mute button than a good book and a warm cup of water. 

    It also helps a lot if we have someone to speak to regarding what’s bothering us. People tell me that it helped just knowing that there was someone on the other side listening to what they were sharing, as well as understanding the strong emotional undercurrent during the conversation. Having someone to talk to, I personally believe is very important to maintain balance in our mental wellbeing.

    2. Your Physical Health

    The pandemic and new norm has created a new breed of couch potatoes. Instead of binge-watching television or Netflix, we’re in danger of putting in unnecessary overtime, all the time. The boundary between your 9-5 identity and your real identity is becoming blurred, and it can be taxing for many people.

    Working from home has disrupted many of the routines that kept us active even on days when we weren’t heading to the gym. Simple things like moving around the office or walking down to nearby shops for a coffee break don’t happen as much when you are parked at your laptop at home.

    The physical barriers between home and work are a little blurry right now (bosses, this is real!) but you have more control over your schedule. Break up a long day of Zoom calls with ten minutes of simple exercise. When you clear your emails, take a long walk. And when it’s time to clock out for the day, turn off your computer, get up and get moving. Even if you have to convert your living room into a gym, just do it. 

    Separating yourself from your WFH routine will help you get the most out of your new exercise routine. For me, I make it a point to get down to the street and jog, even it means jogging in the basement carpark. I also took a deliberate approach on what I ate for breakfast, lunch and dinner.

    3. Your Financial Health

    People who have never set a monthly budget are often surprised by what an empowering experience it can be. The most impactful adjustment you can make to your financial plan is to limit unnecessary spending and maximise savings while continuing to invest prudently, regardless of what’s happening in the markets or on the news. Even if it feels like the one thing we don’t have control of, it could not be further from the truth.

    However, investing can make people anxious during moments of uncertainty, especially if retirement is near, or if they are used to low-risk products like fixed deposits. This is one of the reasons why we revisit the “Life Timeline” exercise with clients at least once a year.

    A financial plan is only as good as your confidence in it. Since most plans are based on assumptions and what was correct at the time of planning, most financial plans may become obsolete as we move into future; we just don’t know how it could go wrong. That is why, regular check-ins and reviews of our plans are crucial to ensure we are on the right track.

    One thing that is certain is that if we take a proactive approach to look at our financial matters and have an idea on how we want things to be managed, that will give us an advantage of being in control over our financial decisions. We are also able to better deal with shocks and surprises.

    The Things We Can Control

    Now let’s take a look at some of the things that we can control:

    • Setting aside money to prepare for future goals
    • Using credit cards to pay (and having the ability to make full payment of the outstanding sum when due)
    • Planning our income tax bill
    • Preparing a medical safety net for our family
    • Paying down our debts, especially bad debts
    • Withdrawing money from our EPF account 1 if the need arise
    • Finding out how we are doing with our money

    Being in control of your financial health, enables more flexibility in terms of how to adapt when things go wrong, resulting in less stress and better mental wellbeing. Times like this offer the best opportunity to discuss how comfortable we are with market exposure, savings goals, debt, and spending.

    The earlier we work to control these, the more we can feel excited about our plans and future. 

    About the Author

    Kevin is a NextGen Money Mentor and founder of NextGen Independent Advisors. He works with people to transform their relationship with money and be brave in their pursuit to live a meaningful life with their money. He is a CFP professional, a certified member of Financial Planning Association Malaysia (FPAM). Kevin can be contacted at www.kevinneoh.my.

  • The Cause And Effect Of Anger

    The Cause And Effect Of Anger

    Everyone experiences this emotion, but knowing how to control it is crucial.

    Overblown anger usually indicates a larger underlying problem in life. Depression, anxiety, and other mental health issues are associated with many magnified negative feelings, some common culprits being worthlessness, shame, and disappointment, all of which can translate into anger.

    Addiction is also a common source of anger, showing up when we get frustrated with ourselves for not being able to stop our compulsions, or to get the fix that would soothe us temporarily.

    What Causes Anger?

    There are two sets of structures in the brain that govern us: the cortex thinks, while the limbic system takes care of the more ancient aspects such as emotions and memories. External triggers, particularly fears, are sent to a deep, central part of the brain called the amygdala.

    The amygdala decides whether to send the incoming data to the cortex for rational processing, or straight to the limbic system that generates quick knee-jerk reactions.

    Childhood maltreatment, poor social adaptation, and unchecked habits sometimes lead to an overactive amygdala, causing us to react too strongly and out of proportion to the actual gravity of the triggering event. Anger becomes an undesirable response when we keep getting uncontrollably irritated against a perceived threat, no matter how small or unfounded it is.

    What Makes Us Angry?

    Anger makes everything seem worse or more important than it actually is. It also makes us feel sure that the things that offend us are true even though we cannot know absolutely whether they are. We feel the urge to exert our will, and we feel justified to let our ego overcome others’ rights.

    Having said that, anger is nevertheless a normal response experienced by everyone in the face of unfairness. Some events in life make us feel deliberately harmed, even when on a deeper level we know that that is not true.

    Such events can cause unforgiving feelings that manifest themselves in anger:

    • Frustration — Feeling victimised when things are not going the way we want them to.
    • Injury — Feeling the need to revenge after being attacked.
    • Exploitation — Feeling the need to set things straight after being taken advantage of.
    • Lack of attention — Feeling small as a result of being ignored or dismissed.
    • Envy / jealousy — Feeling obsessed when someone else has something that we desire.
    • Lack of conformity — Feeling irritated when other people do not obey the rules that we obey or believe to be important.
    • Sympathy — Feeling troubled when seeing someone else suffer a harm that should not be allowed to happen.

    Everyone Expresses Anger Differently

    Even though anger is completely normal, it becomes a problem when we feel it too frequently, too overwhelmingly, or when we express it in ways that can hurt other people or ourselves.

    Noticing our own physical signs of anger is the best way to catch the beast before it overcomes us. Because physical signs tend to show up even when we are trying to suppress our feelings, they are highly useful for those who are used to restraining themselves, but nevertheless suffer from deep-seated and unresolved rages.

    Some of anger signs include:

    • Clenched fists
    • Fast and shallow breathing
    • Stomach in knots
    • Shaking or trembling
    • Sweating
    • Hotness
    • Pounding heart
    • Reddened face

    Apart from classical displays of anger such as verbal abuse and physical violence, many people have learned to express their anger in subtler forms due to social conditioning and habitual inhibition. These are not better or worse than other kinds of aggression, whether self-directed or interpersonal, and should also be monitored mindfully with consistent practice:

    • Passive aggression — “I want to control your emotions or behaviour but I don’t want you to notice it.”
    • Sarcasm — “I want to hurt you verbally and I will force you to take it as a joke.”
    • Contempt and disdain — “I am better than you and you are lesser than me.”
    • Disgust — “You contaminate me or the things I care about.”
    • Coldness — “I refuse to acknowledge you, and I take pleasure in your misfortune.”
    • Hostility — “I am ready to fight you if I have to.”

    How To Cope With Anger?

    Unbridled anger can form a vicious cycle that becomes more aggressive at every outburst and harder to break. The understanding that anger is usually fuelled by an overblown emotional threat is essential to rebuilding a response mechanism that is not based on defensiveness and flight-or-fight reaction, but compassion and rationality.

    Anger can be caused by real problems in our lives that need to be solved, but our ability for problem solving is weakened if we continuously fail to provide ourselves a suitable framework in which to assess life that is based on reality instead of drama.

    Many established anger management techniques are not only meant for emotional de-escalation, but also for helping us to restructure our attitudes and rebuild our empathy, so as to restrain our ego from taking centre stage on every occasion:

    • Maintain a diary to record the thinking patterns and common triggers that have led to your angry outbursts.
    • Recognise the moment anger starts appearing in your body.
    • Observe whether the angry feeling is taking over your logical mind.
    • Do not feel guilty about your anger, but accept that you need ample personal space to avoid lashing out (even though you really want to), and to let the urge flow through you.
    • Practise switching attention to your breathing until the anger feels less urgent.
    • When things have calmed, retrace and revisit the train of thought that you have experienced during the provoking situation.
    • Do not blame yourself.
    • Visualise giving yourself a pat on the shoulder or hugging yourself like a parent would to a child.

    Exploring Our Inner Thoughts

    Therapy and counselling help us understand our anger and learn how to manage it, so that we can limit its negative impact on our lives in scientifically proven ways.

    To gain more insight into our anger, it is useful to ask, “in what ways had this situation hurt me?” and, “am I overestimating the damage that can be done to me?” The answers to these might put things into perspective as we realise that our anger has more to do with our flawed beliefs about ourselves, other people, and the world, than the actual severity of the situation itself.

    After an angry episode has subsided, ask yourself the following questions, and remember your answers when the next tantrum begins to simmer:

    • Do I talk to myself in an overtly emotional language that tends to describe situations as catastrophes, exaggerated dramas, or black-and-white scenarios?
    • Was the situation worth getting angry over?
    • Did I really need to be angry at that moment? Did it solve my problems?
    • Did the pleasure of lashing out justify the harm done (or could potentially do)?
    • How did the effects of my anger impact people on the receiving end?

    We often either use anger as a tool to avoid feeling hurt, or hurt ourselves by directing the rage inwards. Neither pattern is necessarily our fault, but both can lead to bigger mental health problems and social issues. Learning how to control anger does not mean denying ourselves the freedom of expression, but that it happens to be a vital step towards gaining more inner peace and overall contentment in life. 

    Seek the help of a psychiatrist or a clinical psychologist if you often feel unsure, overwhelmed, or out of your depth when confronting difficult feelings.

    This article is adapted from an article by Sunway Medical Centre, Sunway City.

  • Restoring Symmetry – What is Breast Reconstruction?

    Restoring Symmetry – What is Breast Reconstruction?

    Dr Rica Farah Muhammad Abdullah Ichihashi, a consultant plastic and reconstructive surgeon at ParkCity Medical Centre, debunks the misconception that breast reconstruction is cosmetic or aesthetic, and explains that it is actually a procedure to restore the original breast form and symmetry.

    For women in Malaysia, breast cancer is one of the most common forms of cancer that affect them. Treatment for breast cancer sometimes includes mastectomies where part or the entire breast is removed. After the procedure, women have the option of undergoing breast reconstruction.

    Speaking to Calibre, Dr Rica acknowledges that while breast cancer patients are a main group of people that undergo breast reconstruction, any woman whose breasts have been disfigured or mutilated in some way can benefit from reconstruction.

    Consultation & Methods

    Dr Rica explains that more often than not, surgeons treating breast cancer patients would advise and educate their patients on what kind of breast reconstruction procedure to do. “It’s not really something that the patient themselves can choose, because they wouldn’t know what would be best for the situation they are in.”

    Dr Rica Farah Muhammad Abdullah Ichihashi ParkCity Medical breast reconstruction
    Dr Rica Farah Muhammad Abdullah Ichihashi

    Mainly there are three methods—an implant reconstruction whereby a saline or silicone implant is inserted, an autologous or flap reconstruction that uses a patient’s transplanted tissue, or sometimes a combination of both. Because there is also an exhaustive variant of techniques that can be used, some of which aren’t Googleable. It is best for the surgeon to determine which method is best for the patient based on their assessment. An open and comfortable consultation between the surgeon & patient is important. The decision for breast reconstruction and the type would be a joint discussion between the plastic surgeon, the patient and in some situations her family and loved ones.

    For breast cancer patients, Dr Rica stresses the importance of a quick recovery so that the patient’s cancer can be treated, which is the priority. “The aim is for an uncomplicated, quick recovery so patients are ready for any other cancer treatment such as chemo or radiotherapy.”

    Timing & Recovery

    Much like the method, Dr Rica mentions that the timing of the procedure can also vary and is dependent on many factors. Apart from the surgeon’s skill set, other factors to take into consideration are the methods used and the number of surgeons working on the patient at any one time.

    “Sometimes the reconstructive surgeon is the same surgeon taking out the patient’s tumour, so that procedure would evidently take up more time. But sometimes, if two surgeons are working simultaneously, the procedure would be completed quicker. Timing is quite subjective.” On average however, Dr Rica says a typical breast reconstruction surgery can take between an hour and a half to three to four hours.

    “Post surgery, most patients don’t stay in the wards for more than a week. They would return after being discharged a week later for a follow up and to remove their stitches, and more often than not, they are fully recovered between a month to six weeks.”

    As breast reconstruction is a surgery that’s meant to restore symmetry of the breast, there isn’t much change or adapting for the patient post-surgery. They are able to wear the same bras and clothes as before and if needed, proceed to undergoing their breast cancer treatments.

    “Patients are usually also very concerned about pain, but seeing as everyone’s pain threshold is different, I would say it is subjective,” Dr Rica remarks. “Generally however, most patients are home within the week.”

    Considering the Risks

    Like other surgeries, breast reconstructions have similar risks but also some that are specific to this particular procedure. The risk of asymmetry is more common with implant reconstructions, and also carries an increased risk of the rare cancer, anaplastic large cell lymphoma (ALCL). “If a patient undergoes radiotherapy post-reconstruction, they could sometimes be subjected to slight impact on the skin from the radiotherapy,” Dr Rica says.

    With autologous reconstructions, some risks are blood clots, necrosis of the transplanted tissue and weakness, pain or sensitivity around the donor sites. The interruption of the blood flow also can impact the way the tissue recovers post-reconstruction. However, since the tissue is the patient’s own, Dr Rica mentions that recovery might sometimes be faster with autologous reconstructions, and it might also yield better results. Some risk also include interruption of the blood flow to the reconstructed tissues, pain or sensitivity around the donor site.

    Making an Informed Choice

    Breast reconstruction offers women an opportunity for better quality of life, which is pertinent after going through an ordeal such as a mastectomy. By offering women this sense of normalcy after the loss of a breast, the procedure is one that is both healing and empowering. With so many considerations and risks to assess, it is important that women make informed choices about the procedure they choose to undergo, and to also be comfortable with the surgeon they consult with in order to get the best possible care.

  • Preventing Cardiac Catastrophe

    Preventing Cardiac Catastrophe

    Dr Chong Yoon Sin, a Consultant Cardiologist at ParkCity Medical Centre highlights the effects of heart disease and the importance of its prevention.

    Heart disease has long been acknowledged as a silent killer in Malaysia, affecting a large number of the population each year. According to the Department of Statistics Malaysia, heart disease is the main cause of death among Malaysians and has remained so for the past fifteen years. In 2019, 16,325 victims of heart attack made up 15 per cent of medically certified deaths. Furthermore, the onset age for heart disease has also alarmingly lowered in recent years, with the disease being the leading cause of death for people aged between 15 and 64 years old.

    Although there are many ways in recent years to catch heart disease quickly and ample treatment options available for patients, the adage “prevention is better than cure” holds true for the disease.

    Understanding Heart Disease

    Ischemic heart disease, also called coronary heart disease (CHD) or coronary artery disease (CAD), is the term given to heart problems caused by narrowed coronary arteries that supply blood to the heart muscle. A heart attack, or myocardial infarction, occurs when the blood supply to part of the heart muscle is severely reduced or stopped. This occurs when one of the coronary arteries is blocked by an obstruction, such as a blood clot that has formed on plaque due to atherosclerosis.

    Dr Chong Yoon Sin
    Dr Chong Yoon Sin

    When the blood supply is cut off drastically or for a long time, the heart’s muscle cells suffer irreversible injury and die, causing disability or death to the patient depending on how much of the heart muscle is damaged.

    “Sometimes, a coronary artery also temporarily contracts and goes into spasm, causing it to narrow and decrease or stop the blood flow to part of the heart muscle. The spasm can occur in blood vessels blocked by atherosclerosis or regular blood vessel, and when severe causes heart attack,” says Dr Chong.

    Effects of Heart Disease

    It is important to know the warning signs of a heart attack: chest pain, breathing difficulty, profuse sweating, giddiness, epigastric pain, and loss of consciousness. If you notice yourself or someone around you experience these symptoms, it is important to immediately rush to the hospital for treatment.

    “Upon treatment, recovering after a cardiac arrest is a process that requires patients to be committed to avoid a repeat of the incident. Most of the time, after a heart attack, there will be some degree of muscle damage. If the damage sustained by the heart is small, patients will be able to return to an almost normal life except for a stricter diet and medication. However, if the damage is significant, the heart will be weak, causing patients unable to exert themselves as much as they were able to before. Other effects even include breathlessness and inability to drink a lot of water immediately,” explains Dr Chong.

    Preventing Heart Disease

    In Malaysia, heart disease is proven to be caused by the sedentary lifestyle led by a large portion of the population. In addition, Malaysians are also prone to various heart disease risk factors, such as smoking, obesity, hypertension, diabetes, and high cholesterol.

    Many scientific studies show that certain characteristics increase the risk of coronary heart disease, with the four major modifiable risk factors being smoking, high blood cholesterol, high blood pressure and physical inactivity. It is crucial that people control their modifiable risk factors to keep heart disease at bay. Furthermore, if you experience chest pain continuously even if you practise a healthy lifestyle, it is vital that you pay a visit to the doctor.

    “Nowadays we’re seeing patients in their 30s with heart disease due to their lifestyle practices. That’s why I always emphasise on the importance of early detection by going for screenings especially if you have lifestyle or genetic risk factors. It is also important to lead a healthy lifestyle by always exercising at least 30 minutes every day, not smoking, practising a healthier diet by eating more vegetables, fruits, lean meat, fish, beans and so on. Also, cut down on high-fat food, always stay hydrated, and manage your stress better. Once you practise a healthy lifestyle and go for screenings consistently, you will be fine,” assures Dr Chong.

  • Mental Health and Well-being

    Mental Health and Well-being

    The links between mental health and physical health are very deeply intertwined, and there are significant overlaps between these chronic conditions.

    Smart Investor sat with Azran Osman-Rani. ” As an entrepreneur, CEO and Ironman triathlete, many only see my public persona of strength, resilience and energetic enthusiasm to embrace life’s challenges and opportunities. Hardly anyone knows about the recurring anxiety attacks and chronic stress that can leave me either bed-ridden or feeling disengaged and withdrawn.”

    Many do not understand that mental health is just like physical health. Some days we feel physically strong, and other days we become sick – either from an infection that may heal in a few days, or when we are struck with a lifelong or life-threatening disease.

    This can either be from a genetic or inherited condition, or even from being unhealthy from our own lifestyle choices like getting diabetes or hypertension because of poor diet, lack of exercise, smoking and stress.

    Mental health also exists on a spectrum. There’s positive mental wellbeing – when someone is optimistic and curious, focused and resilient, and socially connected. On the other hand, feeling depressed, anxious and stressed is completely normal.

    Most of us can self-regulate and feel better after a few days, but others suffer from clinical levels of depression and anxiety because the triggers that lead to these feelings are either prolonged or so intense that the body can no longer return to normal. It is similar to diabetes where consuming a lot of sugar can cause our blood glucose to spike. If it is only occasionally, for example, having a slice of chocolate cake, the body’s insulin hormones normalise blood glucose.

    However, prolonged and excessive sugar consumption impairs the ability of insulin hormones to regulate glucose and that leads to diabetes. Over time as diabetes progresses, it can cause kidney failure, blindness and even death. Similarly, other hormones control our mental and emotional state, like serotonin and oxytocin. Prolonged stress and pressure, or even intense trauma, can interfere with the functioning of these hormones, causing clinical disorders.

    Other mental health conditions can be brought about by genetic and biological factors, leading to illnesses like psychosis, schizophrenia or bipolar disorders, just like auto-immune diseases or cancer which affect our physical heath.

    The links between mental and physical health are very deeply intertwined, and there are significant overlaps between these chronic conditions. This can be seen, for example, in the relationship between diabetes and depression, or anxiety and heart diseases.

    [ You may read the full article HERE or click below to subscribe our digital copy ]

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  • Eyes Wide Open for Squint Eye

    Eyes Wide Open for Squint Eye

    Squint eye or strabismus can be found in both children and adults, with each of the categories developing it due to a variety of reasons. With squint eye, the key is early detection and treatment, for the benefit of vision as well as the self-esteem of the patient. Dr Norazah Abdul Rahman, a Consultant Ophthalmologist and Paediatric Ophthalmologist & Strabismus at ParkCity Medical Centre, shines the light on the importance of early treatment of strabismus, especially for children.

    By Esvaren Sekar

    Strabismus is the medical term for the condition where the eyes point in different directions, resulting in misalignment of the eyes. There are few different types of squint: convergent squint (esotropia) when one eye turns inward, divergent squint (exotropia) when it turns outward, and vertical squint if the eye turns up or down. These types of squint could always be present or only appear intermittently at certain times.

    Squint Eye in Children

    “Squint eye usually appears in children before five years old, but it can also appear later. And it is not limited to children either, as adults can develop strabismus too. Though the main reason for strabismus is unknown, children with disorders that affect the brain such as cerebral palsy, Down syndrome, hydrocephalus, and brain tumour have higher chances of developing strabismus,” says Dr Norazah.

    In Malaysia, one of the most common cases of strabismus is intermittent exotropia, a condition which allows patients to have straight, aligned eyes when they’re focused, but an eye will begin drifting away intermittently when they are ill, tired or daydream. Once they focus again, the eye will immediately go back to the normal position. Accounting for up to 30 per cent of all ocular misalignment in early childhood, intermittent exotropia starts to develop in a child between one and four years old.

    In addition, another common case is undiagnosed refractive error among children causing acquired squint. For example, when a young child suffers from long-sightedness and has problem focusing on items that are near, they will start forcing their eyes, causing the eye to squint inwards.

    “With children, it is very important for parents to keep an eye out for these signs. Children can be born with squint (known as congenital or infantile squint) and we can detect it as early as four months after being born. Most squints in children need to be evaluated as soon as possible to ensure the vision is protected and to improve the chances of successful treatment. Treatment is to improve eye alignment, and may involve glasses, eye exercises, prism, and eye muscle surgery. If your child has a lazy eye, they may even need to wear an eye patch to improve vision in the affected eye.

    Squint Eye in Adults

    Dr Norazah Abdul Rahman

    For adults, squint eye could either be caused by issues that occur later in life or due to hidden squint eye during childhood that was left untreated.

    “In younger population, we often find decompensated squint, which happens when an adult has squint at an early stage of life, but they managed to control it. So, the squint becomes masked. However, throughout their life, these adults might encounter any events and the squint becomes decompensated causing it to develop again. Most of the time it is trauma related, such as a motor vehicle accident,” explains Dr Norazah.

    Apart from that, stroke also plays a part in squint eye in adults, as the nerve that controls the movement of the eyes in the brain becomes affected. A sign of squint eye in adults is also the appearance of double vision.

    “Most adults who grow up with squint eye due to a lack of awareness. Adults with strabismus may have lack depth vision (3D) or stereopsis, which limits career opportunities. Furthermore, growing up with squint eye may cause the child to be bullied, resulting in low self-esteem as an adult,” says Dr Norazah.

    Treating Squint Eye

    Squint eye in children must be corrected early. “When a child has squint, we first look at non-surgical options for squint correction. For example, if they have refractive error, we give them glasses. A lot of children have good outcomes with glasses and the squint disappears. Some still have squint with glasses but decreases significantly, and we try to correct residual squint with surgery. In some cases, corrective surgery may be undertaken to correct double vision or, in young children, for the two eyes to work together to achieve depth vision,” explains Dr Norazah.

    Meanwhile, adults with squint eye may receive glasses with prism if the angle of their squint is small. Nonetheless if they suffer from headaches or double vision, surgery is the go-to step.

    “It is important for parents to not be afraid of sending their child for surgery if it is needed to treat squint eye. Not only is it very safe, but it will also help the child grow up to their full potential,” assures Dr Norazah.

  • What are The Many Benefits of E-Wallets in Malaysia?

    What are The Many Benefits of E-Wallets in Malaysia?

    “What is your preferred method to make your payment?”

    “We accept cash, cards and e-wallets.”

    “For e-wallet, we accept Boost, GrabPay, Touch ‘n Go…”

    Does this sound familiar to you? This tedious decision can be quite a challenge for those who are indecisive. However, this is a common scenario these days; we’re never short of payment methods although we may be short of funds! Undoubtedly, the rise of e-wallets has given impetus to the evolution of our spending habits.

    Most Popular E-Wallets in Malaysia

    With the help of the government, many are adopting e-wallets through subsidies like e-Tunai and e-Penjana. The three most popular e-wallets in Malaysia are Boost, GrabPay and Touch ‘n Go.

    Boost

    • Backed by Axiata Group
    • One of the pioneers in the Malaysian e-wallet market
    • Accepted at any UnionPay QR merchants
    • BoostUp Reward Programme and CashUp Cashback Programme

    GrabPay

    • Backed by Grab
    • Leverages the Grab Ecosystem for GrabFood, GrabRide and other provided services
    • Partnership with Maybank for cross platform use
    • Earn GrabRewards Points from every transaction

    Touch ‘n Go e-Wallet

    • Backed by Alipay and Touch ‘n Go
    • Taps into the large existing user base of Touch ‘n Go cards
    • PayDirect: link your Touch ‘n Go Card and pay toll fare directly with your e-wallet balance at participating highways
    • Money-back guarantee: full refund within five working days if your e-wallet is charged erroneously

    Irresistible Benefits 

    1. Convenience & safety

    What is the first thing you take when you head out? Your wallet or phone? Frankly speaking, I will often forget my wallet, but never my phone. We heavily rely on smartphones today and with the high adoption of e-wallets among merchants, we can easily make payments without cash on hand. Besides, I think everyone has faced the awkward situation of having to squeeze the notes and “syiling” back into your wallet after receiving your change. With an e-wallet, problem solved!

    The safety of digital payments is also a concern for some, but data in the e-wallets are encrypted and some providers even provide money back guarantee features to ensure the safety of using their services. It can be also argued that e-wallets have helped to reduce theft cases, which usually occurs with physical cash!

    2. A hassle-free spending tracker

    Do you always get shocked when checking your bank balance? Clueless on where the money has gone? You can easily check your e-wallet where all transactions made are recorded. Gone are the days of forgetting where you spent your money. Keeping track of your daily spending is crucial to cultivating good financial habits. This provides an overview of your spending patterns and insight as to where you could improve.

    3. Promotions and rewards

    While having many e-wallets has been confusing for some, the war to acquire users has been beneficial for us consumers. All e-wallets offer their own rewards, and it’s up to you to make the most of it:

    • Boost allows you to earn BoostUp coins with every transaction and exchange for gifts
    • GrabRewards Points comes with an extendable validity feature which technically makes it technically a “never expiring” points system (every point-earning transaction will extend the expiry date of your GrabRewards points till the last day of the 3rd month)
    • Touch n’ Go e-wallet rewards frequent user with cashback vouchers for selected merchants 

    All the e-wallet players partner with various merchants to provide attractive promotions to users in a bid to increase their market share. So look out for where you can save and earn through regular activities like refueling your car, buying groceries or even reloading your mobile credit. But please don’t use these promotions as an excuse to spend more than you need to!

    4. Your one-stop “private assistant”

    Paying your utility bills? Use e-wallet!

    Topping up your mobile credit? Use e-wallet!

    Sending money to your spouse? Use e-wallet!

    The utility of e-wallets is increasing by the day, and are no longer just avenues for sending or receiving money. Many can be used to pay for your parking, buy insurance, settling utility bills and more! There will be definitely more that an e-wallet can do in the near future!

    Curbing Your Digital Spending?

    For some, e-wallets or digital payments makes it easy to overspend with its convenience. Compared to counting out physical cash notes by hand, a big purchase simply requires a scan or swipe. Credit cards already made it easy to spend in the past, so the focus should not be on blaming such platforms, but rather on what you can control in terms of your spending habits:

    1. Set a monthly top-up limit 

    To avoid overspending, you must know how much you have. For example, if your spending budget is set at RM500, only reload RM500 into your e-wallet and make sure it lasts the whole month! If you’re out of credit before the month is over, you’ll know you need to fix your spending habits. Don’t top-up until next month as a reminder to stick to your budget!

    2. Only reload with your bank account or debit card

    I understand many will argue that we should optimise rewards on both ends by reloading e-wallets with credit cards. However, from a licensed financial planner’s perspective, this is not necessarily suitable for beginners who have just started to learn how to manage their spending. Only use this option when you are confident about your financial planning. If not, please don’t borrow money from your credit card to support your e-wallet spending habits!

    About the Author

    Ocean Pon is a Licensed Financial Planner and likes to help millennials make wiser financial decisions to achieve financial independence. He can be contacted at oceanpon@finwealth.com.my.