Aah...This Thing Called Ageing

Of late, I've been seeing flashes of light at the corner of my left eye when driving at night.  At first, I thought that my prescription glasses needed checking but when I removed my glasses, the flashes were still there.  I then sought advice from Dr. Google who informed me that it could be due to either (1) ocular migraine or (2) torn retina.  Whilst (1) is just a mere nuisance, (2) could potentially lead to permanent blindness.

A check with an Opthalmologist confirmed that I had a condition called PVD (posterior vitreous detachment).  What on earth is this beast called PVD?  The Opthalmologist patiently explained it thus:

When we look at something, light passes through the front of the eye, and is focused by the lens onto the retina. The retina is a delicate tissue coating the inside of the eye. It converts the light into electrical signals that travel along the optic nerve to the brain. The brain interprets these signals to 'see' the world around us.

The eye is filled with a clear jelly-like substance called the vitreous gel. Light passes through the vitreous gel to focus on the retina. When the vitreous jelly comes away from the retina this is called a vitreous detachment.  The movement of the vitreous away from the retina at the back of the eye creates a tug on the retina.  The retina reacts by sending a small electrical charge to your brain.  You see this as short, small, flashes of light.

The cure?  None.  The coming away of the vitreous gel from the retina is a process that can take to about 6 months.  When this evolution is complete, normal sight is restored.  However, if the following symptoms appear, then a visit to the Opthalmologist is mandatory; if not immediately, at least within the next 24 hours:

• A sudden appearance of floaters or an increase in their size and number.
• Flashes of light and/or a change/increase in the flashing lights you experience.
• Blurring of vision.
• A dark "curtain" moving up, down or across your vision, as this may mean that the retina has already partially detached.

Aaah...this thing called ageing!

Integrative Medicine - Ozone Therapy

LBA (lab blood analysis) and body composition test shows the following results:

1)  Cancer Marker:    Negative (thank Allah!)

2)  Overall fat:   Very high

3)  Visceral Fat (fat around organs - most dangerous that can cause heart conditions, stroke, 

      etc):   Very high

4)  Subcutaneous fat (fat under the skin): all below normal (due to exercise, which is good)

5)  Skeletal muscle: High (which is good - again due to exercise)

6)  BMI:   Obese

7)  Body age: 77 vs actual age 61

LBA also shows that every organ is my body (heart, kidney, liver, spleen, etc.) is not working at optimal level.  Apart from bad dietary habits and medication, another factor contributing to this condition is the surgery that I had undergone in 2007.  It was a surgery to remove the gall bladder due to stones.  However, during the procedure, the surgeon had accidentally nicked the central bile duct (CBD) that caused bile to flood into my abdomen.  Bile is toxic and it has caused damage to the internal organs due to peritonitis.  However, I was lucky that I was treated before more damage was done to the organs – I had an abdominal surgery and 2 litres of pus was drained from my abdomen and I was treated with antibiotics.  I was told by the doctor who did the LBA that peritonitis is potentially fatal if not addressed immediately and it affects the well-being of one’s internal organs.  Learning about this now makes me understand why my surgeon, Prof Razman Jarmin of HUKM, told me that a majority of his patients who had similar conditions to mine, usually continue to see him for between 5 – 10  years from the surgery. 

The above revelation really opened my eyes on my overall health condition.  I thank Allah that I had survived a potentially fatal condition in 2007 and I decided to try Ozone Therapy as a preventive measure before more serious health issues arise.  It is also time to adjust my eating habits and exercise regime.

Ozone Therapy originated in Germany in the 18^th century although it had also been used in ancient civilisation.  It involves introducing controlled doses of ozone into the blood to rid the blood of plaque, toxins and other free radicals that we get from the air we breathe, food, medication, lack of exercise and our unhealthy lifestyle such as smoking.  The blood goes through a process of “cleansing” when ozone is added and blood is re-infused into the body.

Ozone therapy is a simple naturopathic medical procedure that improves both circulation and utilization of oxygen by the tissues. Circulation is improved as ozone decreases the thickness and viscosity of the blood, and may stimulate dilation and relaxation of the artery walls. This can help compensate for blockages in the arteries from fats (atheromatous plaques).  Ozone therapy strongly stimulates both proper circulation (delivery of oxygen), and proper energy generation (utilization of oxygen). The cells in your body, including the heart (angina), muscles (claudication pain) generate their own energy for use. Oxygen is vital to this process. If the cells can generate enough energy, there will be less fatigue and less pain. Ozone helps with both oxygen delivery and with the way the cells use oxygen once it has been delivered.

Ozone also has very well-defined effects on the immune system, particularly by regulating the activity of the white blood cells. This makes it extremely useful in allergic and autoimmune conditions.

Ozone consists of 3 Oxygen atoms, whereas Oxygen has only 2 oxygen atoms. It is this extra oxygen atom which gives ozone its instability and its power.  The extra oxygen atom is not comfortable where it is, and it makes the ozone very unstable. This extra oxygen atom wants to immediately attach itself to something else to find stability and to release an oxygen molecule.

Let’s take for example how ozone works to neutralize viruses or bacteria and other pathogens (an agent that causes disease, especially a living microorganism such as a bacterium or fungus).

When ozone comes into contact with a virus for example, it immediately disrupts the very delicate and frail viral cellular envelope surrounding the viral organism. This leads to a breakdown of the viral cell wall and also a rupture of the virus, leading to its destruction.  Ozone therapy  has been proven in studies to be able to destroy virtually all viruses, some more so than others.  It has also been successfully used in Germany to treat HIV.

Ozone therapy is a medical act and must be done by a professionally-qualified medical practitioner.  The doctor that I visited has been practising Integrative Medicine for the past 28 years.  Integrative Medicine is a blend of western and alternative medicine.  Integrative medicine is fast gaining popularity in Malaysia as cure for certain conditions such as cancer, diabetes and heart conditions and also as preventive measure to maintain good health.

Detractors of ozone therapy claim that it is dangerous to introduce ozone into the blood because when you mention ozone, most think of smog and toxicity.  Rising incidence of asthma and other respiratory disorders in polluted cities bear testimony to this line of thinking.  Yet, on the other hand, experts warn us that the depleting ozone layer in the atmosphere are putting us in danger of cancer as the ozone layer fail to block out the ultraviolet rays from the sun that cause cancer.  In this instance, ozone is seen as good.

Many people do not seem to realize that ozone in pure form and ozone mixed with pollutants behave differently. (Furthermore, the ozone layer in the stratosphere has a different impact on humans than that on a beach.).  Many people have benefited from ozone therapy so the jury is still out there on this form of therapy but I am willing to give it a try given the current state of my health.

 Toxins and proteins removed from the blood.  Excess protein (bubbles) in the blood may indicate immune system disorder

Procedure is carried out in a clinic setting

         Blood  (dark in color ) is drawn from the left arm and re-infused into the right arm (blood is lighter in color after being infused with ozone)

    

On The Brink....

NOTICE: THIS POST CONTAINS GRAPHIC IMAGES OF SURGICAL WOUNDS THAT SOME MAY FIND DISTURBING. VIEWER DISCRETION IS ADVISED

It was a relatively simple surgical procedure – a cholecystectomy – surgical removal of the gall bladder due to stone in the bladder. The procedure was done laparoscopically and I was discharged after 2 days. By the fifth day, I felt fine enough to drive. However, the seventh day (May 7, 2009) brought on acute stomach pain accompanied by vomiting. The pain grew progressively worse, spreading to my back and shoulders.

At about 1.30 p.m., I was admitted into the Emergency room of the same hospital where the surgery was carried out. An injection was given to help me deal with the pain. However, inspite of that, the pain continued and I requested, and was given, a second injection an hour later.

Although I was in acute pain and repeatedly requested for the surgeon, I was told that he was busy attending to patients in his clinic and I had to wait. Given my condition, it would have been comforting if the surgeon had dropped by and checked on me, even if for a while…his presence would not immediately cure my condition but would be a demonstration of a caring attitude…but maybe that was too much to expect? Sick patients do not just need medical care; they also need empathy and emotional support. I would not be surprised at such indifference if I were in a government hospital – but this was one of the well-patronized private hospitals in the Kelang Valley.

The accommodation I requested was not immediately available so I continued to wait in Emergency. Finally, at about 4.30 p.m., I was temporarily admitted into a suite and until then, there was still no sign of the surgeon. He finally appeared at 6.30 p.m. (5 hours from the time I was admitted into Emergency) and announced that it might be gastritis. Gastritis? I have never had that condition in the entire 5 plus decades of my existence; but since he is a doctor, I believed him. Medication for gastritis was administered.

In the meantime, more tests were carried out and on May 10, an MRI (x-ray) was conducted to confirm what the problem was. The x-ray showed that there was fluid in my abdomen, suspected to be caused by a leakage of bile into my system. The leakage was suspected to have occurred at the site where the bladder was clamped after removal. I was told that the condition could be managed in one of two ways – performing an endoscopy or administration of antibiotics. The surgeon advised that the former was an invasive procedure considering that I just had surgery and recommended the latter since the leakage was slight; judging from the time lapse from the date of surgery and the condition at hand.

Unable to endure the pain and placing my complete trust in the surgeon's professional opinion, I agreed to be treated with antibiotics for the next four days. By that time, I had developed fever and signs of jaundice (the whites of my eyes turned yellowish), my abdomen was bloated, my urine was the color of dark tea and my stool was greyish in color. My protein level had also fallen and I was given liquid protein intravenously for three days.

On the eighth day, the surgeon advised me that the leakage could not be fixed at the hospital and recommended that I be transferred to a teaching hospital of a local university where specialized services are available. I was transferred to that hospital in an ambulance on Friday, May 15.  At this hospital, I was assigned under the care of a surgeon specializing in hepatobiliary and pancreatic conditions.

The surgeon examined me later that evening and told me that he had scheduled for endoscopy the following day (a Saturday) when he would insert a stent to stop the leakage. After this procedure, he told me that he had to go out of town for the weekend and would check on me the following Monday.

In the meantime, my fever continued and at about 9 p.m. on Sunday, May 17, the surgeon showed up and told me that he had to return from his trip as I required immediate surgery. A laparotomy (abdominal surgery) was done at about 11 p.m. and when I woke up at about 3.30 a.m. the following day, I found myself in the High Dependency Surgical Ward of the hospital.

My condition had been life-threatening - the surgeon had drained about two litres of pus from my abdomen (I was suffereing from septicemia) but the worst was over. He confirmed that the leakage was caused by an injury to the common bile duct; which occurred during cholecystectomy.

On learning this, I freaked out; angry that I had to suffer physically and emotionally for the apparent negligence of a medical professional at an exhorbitant cost (total ~RM27K). I was still on dribs, I could not walk to the toilet for bodily functions and had to wear diapers, and I hated the tubes that stuck out from my abdomen, draining bile into a pouch that I had to carry. I had bouts of asthma due to stress and from there on, I went downhill emotionally to the extent that I required psychiatric help to cope with my condition. Although the worst was over, those were the darkest days of my life!

Bile Flowing out Post Surgery

Infection at surgical site

During the month-long hospital stay, I had to undergo physiotherapy to rehabilitate - not only due to the surgery but also other conditions caused by immobility as I was bed-ridden for three weeks. I also had to deal with an infection at the surgical site.

My condition requires long-term care and today, I still have a stent in my bile duct. This experience drove home the reality that life is fragile, temporary and fleeting. Since then, I have learnt to live for today and be thankful for what I have. I turned to prayers to give me the strength to go on and I wake up every day thankful that I have my health again. The laparotomy was my thirteenth surgery in the last 20 years, three of which were botched jobs that required follow-up surgeries, and these were all performed at private hospitals with supposedly specialist expertise.

Someone once said, "life is not about waiting for storms to pass - it is about learning to dance in the rain", and I am indeed learning to dance in the rain!

Bekam

Bekam (or bloodletting) is the withdrawal of often small quantities of blood from a patient to cure or prevent illness and disease. In English, Bekam is known as cupping.

in Arabic, Bekam is called “Al-Hijamah”.  The word “hijamah” derived its origin from the word “al-hajm” which carries the meaning: to suck, to absorb, or to extract.  The practice of Bekam was practised by the Prophet Muhammad PBUH (570-635 AD) as evidenced in the following hadis: 

Rasullullah S.A.W. said," Jibrail Alaisalam repeatedly emphasized upon me to resort to cupping to the extent that I feared that cupping will be made compulsory."

(Jamul' Warsaii p.179).

Rasulullah S.A.W.  praised a person who performs cupping, saying it removes blood, lightens the back and sharpens the eyesight.

(Jamul Warsaai p. 179).

Anas ibn Maalik r.a. reported that the Messenger S.A.W. said “Indeed the best of remedies that you have is hijamah (cupping)”.

(Saheeh Al-Bukhari [5371])

Abu Hurairah r.a. reported that the Messenger S.A.W. said “If there was something excellent to be used as a remedy, then it is hijamah (cupping)”

(Saheeh Sunan abi Dawud [3857])

(Saheeh Sunan ibn Maajah[3476])

In modern-day Bekam, the practitioner first determines the part of the body that requires cupping - for migraine, it is the scalp.  Punctures are then made to the scalp (after shaving the pre-determined site).  A cup is attached to the skin surface to cause local congestion through the negative pressure created by introducing suction. This draws up the underlying tissues. When the cup is left in place on the skin for a few minutes, blood stasis is formed and localized healing takes place.  In olden days, buffalo horns are used for suction; in fact, this is still being used today in Malaysia.  After blood is removed, the area is cleansed using antiseptic swabs.  Disposable needles are used to puncture the skin.

Toxic blood of a migraine sufferer

Is Bekam painful?  Although many people claim it is painless, I found it painful when the skin is punctured (due to my lower pain level tolerance?).  When suction is introduced, it is also painful but after a while, the pain subsides.

Proponents of Bekam claim it is effective in its curative use in eliminating pain, restoring physical functions and in preventing as well as healing of diseases. Frequent usage will eventually remove the excess humours (blood, phlegm and bile) and toxic waste present in the blood vessels and muscles under the skin. In short, if given time, this method can slowly “overhaul” the whole body generating optimum health, thus contributing to a true preventive health care programmed which we are badly in need of.

Down Memory Lane....

My recent extended hospital stay had done a lot to me…I reflected, I got philosophical…I learnt to count my blessings and I learnt who my TRUE friends are! I also reminisced about those people whose paths I’ve crossed and who had been instrumental in shaping my views on things that matter in life and who taught me that if you let the system s**** you, it will!

Dr. B. Jagdev Singh was a senior partner of Drs. Young, Newton & Partners, ExxonMobil’s panel clinic. When he retired from Young & Newton, Dr. Singh signed a contract to become the Company’s Medical Advisor responsible for occupational health. I was then the Company Medical Plan Administrator and we collaborated on employee health issues.

Dr. Jagdev Singh is now the Chief Medical Assessor, HM Aerospace Sdn. Bhd., Malaysia's largest aviation training center.

Dr. Singh was, and is still is, a proponent of government hospitals (UM in those days) whose main objective is to treat patients and are not bottom-line driven. He is also of the view that the standards of medicine in this country are not stringent enough compared to, say, Australia where one needs to go through a number of years working in government hospitals (usually out in the boondocks) before one can become a specialist.

Hence, in Malaysia, we see many doctors who are "still wet behind the ears” (Dr. Singh's favourite phrase) coming out to practice as specialists and this is one of the factors contributing to the number of medical negligence cases.

He is also not in favour of giving employees a free rein to choose hospitals based purely on comfort and not care. Corporations pay millions of Ringgit annually for their employees’ health care and much of these expenses have gone to “frills” provided by hospitals rather than necessary medical care.

Instead of treating medical conditions, some have caused medical conditions through botched procedures, thereby not only increasing company’s health care costs but also resulting in loss of productivity, etc.

As an HR person, I agree that in order to manage health costs, there has to be some form of control by the Company as the rate of medical inflation (according to insurance companies' statistics) is close to 20% per year! Uncontrolled medical costs not only affect companies but also their employees who must share in the costs.

But I also tend to sway towards giving employees some degree of freedom to choose – for sometimes, employees wish to use certain hospitals they are familiar with. However, there has to be a caveat - i.e. if the hospital is known for "over-charging", then the Company has the right to step in...this, currently, is already taken care of as most companies' medical plan is administered by insurance companies who ensure that "pricey" hospitals are not covered by guarantee letters.

Dr. Singh and my team spent hours in meetings discussing employee-related health issues, over-charging by some hospitals, and how to institute some form of control on the company’s medical plans so that we get value for money. We also visited hospitals and the Ministry of Health regarding the Company's guarantee letter, and for Dr. Singh to inspect facilities of new hospitals that employees may use.

Ours was like a father-daughter relationship. On the one hand, he would reprimand me for looking for an easy fix to manage my weight problems (Duramin); on the other, he called me “my sweet chappati” (I was only 30-something then, ok?) and would treat me and a few other ladies to chappati under the tree somewhere along Jalan Sungai Besi. Another of his favourite joint is Kelab Aman (the Sikh club) on Jalan Aman, off Jalan Damai. So, how to lose weight lah?

Dr. Singh, I learnt a lot from you about the medical field, “behind-the-scenes” exploits of some hospitals that has prompted me to ask questions, not to take doctors' advice as gospel and I appreciate your concern about my well-being when you told me “no Duramin, exercise more, eat less, don’t be lazy!”.

Don’t forget you promised to take this “sweet chappati” for lunch at Kelab Aman….but this “sweet chappati” is now in such a mess and has turned into “masala (problem) tosai”….but never mind, doc, LIFE GOES ON - masala tosai aside!

Say hi to Neeta for me...is she a practising lawyer now?

Comedy of Errors!

Story of my life....need I say more???

....And Life Goes On

A friend of mine, who's been following my blog, called recently to ask if I am REALLY sick. "Looking at your pics on your blog and reading your Face Book comments, you seem like you're having a ball of a time....no need to work, going for manicure, pedicure, shopping, etc...while poor souls like me are working my b*** off! Are you really sick?"

I replied that I am really sick and I am still being treated but I don't want to put my life on hold while my health is taken care of. After what I've been through, I know that life is short, so I don't waste my time worrying about what might have been....the reality is "what is".

As for working her b*** off, I reminded her that I'd worked for 32 years and I have paid my dues...now it's "me time!" I used to worry about everyone and everything else (my family, my job, the recession, my cat) that I don't have time to worry about myself. But now, I am determined to be "selfish" and put me first. If I feel like taking off and having a break somewhere else, I will...if I can find someone to accompany me, that is!

I would like to emulate the late Ms. Wong Hoi Wan, who was the Chairman's Secretary at my former place of work. Hoi Wan (God bless her soul) had breast cancer but she lived her life right to the very end doing things she loved doing such as playing tennis and even things she'd never done before such as karaoke-ing and long lunches with friends.

Each time I put on my golf attire to join my friends at the golf course, my mum would fret that I should not be too "gungho" while recovering...that I should stay home to recuperate...that complications to my illness is caused by my not observing all the "pantang" (forbidden things) after surgery.

"But mak, if I stay home I'd be miserable and that will not help my recovery. My friends are my life, and being out on the golf course is therapeutic...I enjoy the camaraderie, bantering and "cakap merapu" with the girls. So, please understand that I am healing rather quickly because of my determination to live my life to the fullest - and not because I am at home moping about my health".

So, to all who know me out there...if you see me up and about and having fun, you know what's going on!

"Life is like a game of cards. The hand that is dealt you represents determinism; the way you play it is free will" - Jawaharlal Nehru

Relax, Rejuvenate, Recuperate (3R)

Today (June 5), I am at Eurosense Day Spa, Taman Melawati, for facial, manicure, pedicure and hair wash. I have been a faithful customer for many years now as I am one who loves to pamper my body. My weekly routine is a 2-hour massage after golf on Sundays with Indonesian masseuse Bibik Su at another massage center…rejuvenating!

Nash dropped me off at 1.00pm and I told the staff that I needed to be back at HUKM by 4 pm for physio. Since there is a time crunch, the Eurosense Dream Team mobilised their staff to attend to me.

A gentle massage....

While Prilicia attended to my oxygen facial (process involved using oxygen to rejuvenate the skin), Apple did my manicure and pedicure. Nash bought me a quick lunch of yong tau foo and the girls bought me fruits.

Pedicure

Manicure

Oxygen mask to let the skin breathe

This was followed by hair colour and treatment by stylist Daniel after which stylist Sylvia cut my hair as it is now out of control. I have naturally wavy hair which tends to curl all over if I do not blow dry.

I had to call HUKM to cancel my physio as it was not possible to finish by 3.30 pm. By 5.30 pm…viola…I felt brand new…lighter and happier. Since Nash could not leave the studio due to recording an album for an out-of-town band, Daniel sent me home.

Eurosense Dream Team
(Back: L to R) Stylists Daniel & Sylvia (Front: L to R) Apple, Firasyie, Prilicia

“God bless you..you made me feel brand new”….Stylistics

Wind Out Of My Sail - Part IV

It was a trip I will always remember. During the drive to Penang, although we had a business agenda, all we talked about was the gastronomic adventure awaiting us and visions of nasi kandaq, lien chee kang, apom, rojak and tea at E&O Hotel danced before our eyes! Torah and I recalled with nostalgia our experience growing up in Penang way back when....

Upon arrival, after a brief meeting, we had a great lunch of nyonya food, courtesy of Dr. Noraini, at a marina (can't remember the name now). We then checked into the apartment and that night had a sumptious seafood dinner, courtesy of Dr. Noraini's friend, Kate. After dinner, I felt a slight pain in the right side of my abdomen but thought nothing of it.

Dr. Noraini, Torah & Amran at lunch

The next morning, Sujan took us to Pasar Pulau Tikus which is just a short walk from the apartment for breakfast consisting of apom and teh tarik at a mamak stall. Later, inspite of the pain, I managed to join Torah in doing our part to contribue to the economy of Pulau Pinang - between us, we bought pisang raja, bunga kantan, asam jawa, asam keping, belacan, penyapu ruman (broom!) and even a pair of fake designer reading glasses!

As the pain became more acute, especially when I stood up or bent to pick up something, I took a painkiller and even applied medicated plaster, thinking that I had a muscle pull.

When we got to Dr. Noraini's office, I went to a clinic and the doctor said it could be stones in the gall bladder. He asked me to get it checked when I return to KL and gave me a jab to tide me over the journey home.

We managed to conclude our meeting but half an hour later, the pain became worse - it was excruciating and had spread to my back....I imagined that was how it felt when being stabbed by a knife! At this point, we decided to forego lunch (there goes the long-awaited nasi kandaq!) and return to KL.

Before returning to KL, I was taken to Gleneagles Hospital's A&E Unit for an ultrasound scan to determine if I was in a condition to travel. The scan confirmed that I had a stone in my gall bladder, about 1.5 cm in diameter. I was given another jab to last until I return to KL.

At Gleneagles' A&E Unit

The next day, I consulted a surgeon at Ampang Puteri Hospital and was wheeled into the operation theatre at 11.30 am for a surgery. That was my 12th surgery in the last 20 years and I am frankly very tired of getting anaesthesized and cut up! Thoughts of "why me?" have begun to creep in but I must be strong and fight them.

The culprit!

During my hospital stay, Torah lent me a book by Dr. Robert C. Fulford titled Touch of Life. Dr. Fulford is a proponent of osteopathy - healing by releasing blockages in the muscoskeletal systems. It is an alternative form of medicine and I am now willing to try alternative medicine to avoid any more surgeries in future. Also, it is time to seriously lose weight and watch my diet!

Wind Out Of My Sail.....(Part III)

It's been 11 days since I had surgery for torn rotator cuff and today, I visited with the Orthopaedic Surgeon (OS) to remove the sutures and have the wounds cleaned. The following are pictures before and after the sutures are removed and as can be seen, the shoulder is still fairly swollen.

The shoulder no longer hurts but it is stiff and the only movements allowed are forward/backward and sideways. I cannot reach behind to scratch my back, for example, and I also have to wear front-buttoned shirts as I cannot raise my arm to get into my clothes.

Today, I also had my third physiotherapy session to get the arms moving and the most painful is when I have to push my arm sideways against the wall - the muscles must have gone to sleep and I felt like someone just hammered my injured arm! My Therapist, Jeffrey, advised me that for the first 6 weeks of therapy, my movements are limited and I can only do other "less boring" movements after the sixth week. I will be allowed to do similar exercises in the swimming pool one week from today - not to swim, mind you, but just to move my arms in the water!

But the best news I've heard so far is that after 6 weeks, I can try putting - in fact, one of the movements I do during therapy is to move the arms sideways like a pendulum - just like putting! Come to think of it, it should improve my putting as I cannot move my arm any other way except sideways - didn't they say in every cloud there is a silver lining? Oh well.....four more weeks to go!

Wind Out of My Sail....(Part II)

I have been through many surgeries before and I thought this time, it would be different - but I was wrong! Each time before a surgery, I have knots in my stomach dreading the thought of anaesthesia, getting into induced sleep and waking up feeling nauseated and disoriented. But I have made up my mind to do it and I just had to get on with it. On the day prior to surgery, I went through blood tests and chest x-ray to ensure that I was fit for surgery. The anaesthetist then visited with me and explained what was going to happen - since I already knew what was going to take place, I was really feeling anxious and I guess it must have showed on my face! The anaesthetist must have noticed this and suggested that I take a sleeping pill the night before to help me sleep.

I woke up early on surgery day, had a bath and dressed in hospital gown. Before leaving the room, I was given a pill to calm my nerves after which I was wheeled into the operating theatre. The doctor had not arrived and the waiting was pure agony! I tried not to think about what's ahead - but it was so diffcult to think of anything else as I lay on the operating table in a cold, sterile, environment with bright, blinding lights shining into my eyes. I have always been a brave person - I had to be brave to jump out of a plane - but this was different. At this moment, I wondered whether I would have preferred to jump out of a plane instead!

Then came the most dreaded moment - the anaesthetist arrived, patted by hand and asked me to take a deep breath. From past experience, this was the most difficult moment. I have very fine veins that are difficult to locate and once the needle is inserted, the veins tend to burst, making it difficult to inject anaesthesia. The process had to be repeated several times and I tend to resist, making it more stressful and painful. During my last surgery, I woke up to find that I had needle puncture marks on both hands, both feet and a needle was stuck into my neck. This time, it was not too bad; the prick was not too painful and then I was given oxygen to help my breathing. At this moment, I repeatedly recited the kalimah syahadah. The kalimah syahadah is the first pillar of Islam and it is an affirmation of one's faith - it is also recited before one's death. I do this every time before surgery as every surgery carries an element of risk and I don't know if I would make it. Almost immediately, I drifted off into oblivion!

The next thing I knew were some far-away voices calling my name, like in a dream, someone gently slapping my cheeks, asking me to open my eyes. As I opened my eyes and became aware of my surroundings, the after-effects of anaesthesia started to set in - I did not throw up but my vision was blurred and my world was spinning! I tried to speak but could not; I could hear the doctor asking me if I was okay; I weakly tried to say yes, then he asked me to move my fingers and I did.

I was returned to my room and drifted off into morphine-induced sleep again - everything is okay for now and the next phase would be rehabilitation!

With Orthopaedic Surgeon, Dr Charanjeet Singh

Wind Out of My Sail (Part I)....

It started as a nagging pain and I thought it could be due to too much golf. Maybe a little rest was all I needed. But when my left arm started to throb at night and painkillers did not provide enough relief, I suspected something was amiss, as the pain was familiar. It started in the upper arm and radiated towards the shoulder and it was intense when I lay down!

A visit to the orthopaedic surgeon (OS) and an MRI later confirmed what I thought...that I had a torn rotator cuff in my left shoulder. The OS advised it was a full tear that will not heal on its own and I should have it repaired. I decided to seek second and third opinions before making that final decision. The second OS advised that I should have a steroid injection as the pain appeared to affect the tendon more than the cuff. He advised that I should wait 2-3 weeks after the injection before deciding on the next course of action.

The third OS, who specializes in sports injury of the shoulders and knees, did a thorough examination of the shoulder and noted a popping sound which was caused by a spur that had developed as well. He advised against injection as it would only treat the pain and not the underlying cause. In fact, when a tear is involved, he'd rather that nothing be done instead of taking an injection because when there is no pain, the patient may continue doing whatever it is that caused the pain, resulting in further damage, thus complicating the repair.

My options are (a) do nothing and live with the pain and a weakened shoulder, which may degenerate beyond repair with age, even if I give up golf, or (b) have the shoulder repaired. There are two options for repair - open surgery or arthroscopy. It was not very difficult for me to make a decision. I had done my research on the Internet and I am not one to agonize over things that I know will not work...and, by the way, this includes relationships as well!

After discussing the pros and cons of open surgery versus arthroscopy with the doctor, I have decided to go for arthroscopy and will have the procedure done soon - this will be the subject of another post when it is done.