Holistic Approach to Healing

I am one who usually bounce back from surgery very quickly. I want to get well, fight the urge to wallow in self-pity and do whatever I am supposed to do. My ability to bounce back so quickly has drawn comments from friends and doctors alike.

I attribute this to my strong belief that healing must be approached in a holistic manner - medical intervention, the patient's will to get better, physiotherapy, psychiatric counseling, nutrition, belief in religion/ spirituality, strong family/friends support network, a positive attitude, aromatheraphy, etc.

I have seen many cases where the patients seemed resigned to their fate. During therapy, there is a blank look on their faces and they seemed to have already been defeated mentally and don’t want to try.

They say “I can’t” and just refused to help themselves. It saddens me to see that because I have always been a fighter and my will to get better is so strong, that I am willing to face pain. Obviously, to the extent possible, pain should be minimized but if pain is part of the process, so be it. I have screamed, cried, huffed and puffed...but I still go through it!

1. Medical Intervention

Patients benefit from a medical team that is not motivated purely by profits. In a capitalist world, we do expect all you private doctors out there to "make money" but don't let material gains cloud your professional judgement. Remember the Hippocratic Oath (or, has this now become Hypocritic Oath)? Stop passing patients around to your fellow surgeons for procedures that are not medically necessary, just to inflate the bill - especially if the patient is covered by his employer's Letter of Guarantee.

After having patronized private hospitals for the last 32 years of my life, I am very tired of "bottom-line-driven" medical advice/procedures resulting in dire consequences. The layman patient looks up to the specialist doctor as his/her saviour so please, don't let the patient down. As a doctor, if you have made a mistake (doctors are humans too), fix it quickly. If you cannot fix it, ask someone else who can and do so in a timely manner. In medicine, just like in law, time is of the essence!

With attending surgeon, Prof Madya Dr. Razman Jarmin

- General, Hepatobiliary & Pancreatic Surgeon

Prof - I must confess that when I first saw how young the members of your team were (I guess average age of the group would be below 40?), I was worried ("so young ah...die lor...."). But when I heard them discuss my case with you on each visit (I may appear "drugged" but I was lucid), I knew I had come to the right place! With the Grace of Allah and your skill, I have been saved - for which I am eternally grateful!

2. Patient Cooperation and Will To Get Better

If a patient can “feel” the specialist is genuinely concerned and wants to help, the patient will cooperate. Even if the patient is initially reluctant to try, the medical team (including physiotherapists) should coax them gently to win them over.

I have seen patients refusing to even try to do therapy but with coaxing and patience, the patient finally cooperates. It’s almost like dealing with a child – coax gently and reward successes with praises, talking, etc. I, for one, do not have the inclination nor energy to go the extra mile but these young support staff (therapists) really try to make a difference. If they do not succeed , they keep trying.

3. Support of family/friends

Sick patients need the support of family and friends, some more than others. Depending on the patient’s psyche, family and friends should rally around patient to encourage healing. The keyword is “encourage” not “get in the way”. I have seen family members so concerned that they hang around even outside of visiting hours and are really tiring the sick person who needs rest.

KDE Lady Golfers (L to R): Audi, Irene, Winnie, Mahani

ExxonMobil Alumni

(L to R) Jamilah (Jam) Hafziah (Zia) and (Sitting) former nurse, Sister Hamie, Capt (R) Royal British Army

I am one who like to see as few visitors as possible when I am ill – I want to rest because I know I am under good care. When there are too many visitors – even if family, the patient in all probability will be asked what happened, hence tiring the patient further, including causing unnecessary emotional reactions.

In my case, when I was in HDS (High Dependency Surgical) ward, I told the nurses that I needed to rest and could not see visitors and I pulled the curtains around me. They were advised to check back later before dropping by.

My son handled this situation very well I thought. When friends/relatives called to enquire where and how I was, he would say that I was ill but I was under good care and to leave me alone for the next week or so. There is no need to repeat details because in many cases, the message becomes distorted when passed to many people. Next-of-kin will be constantly updated by the attending specialist but keep that information on need-to-know basis only.

When visiting a sick patient, please, for goodness sakes stop saying things to make the patient feel sorry. One visitor kept saying “you poor thing, I heard you were really ill” to which I replied “please don’t tire me because I am ill - I am under good care and there is nothing to worry about. I want to be understood, not pitied” This will not lead to negative and toxic thoughts and usually will cut the visit short.

As a non-family visitor, plan to spend no more than ten minutes with the patient. Just tell the patient you are there if needed and avoid asking what happened unless the patient volunteers the information. Patients should not feel obliged to volunteer the information.

4. Religious/Spiritual Belief

Many people (yours truly included), in their hour of need, turn to religion and this helps in healing. It does not necessarily have to be religion – it can be spiritual as long as the belief is strong.

Mobile phone with "azan" (call for prayer) feature based on longitude and latitude positions of location

"Qibla" feature to determine direction of Mecca for prayers

5. Nutrition

Nutrition also plays an important part in healing as the patient needs strength in order to get better. In some cases, patients need special diet (e.g. low fat, soft diet, etc.).

I am very blessed to have friends who consider me family and who are excellent cooks. They have volunteered to take care of my diet because they miss this “golf kaki” lor!...no seriously, they genuinely care! Thank you girls....now I know who my TRUE friends are!

Essence of Black Fish - for healing internal wounds

6. Physiotherapy

As an active person who has spent the last few weeks lying in bed, I find that physiotherapy really helps because I have developed aches due to inactivity. I really look forward to physio and I do the exercises I have been taught in my room.

I can now take the lift/walk to the Physiotherapy Department (located at the basement) unaccompanied because I am strong enough to walk and I want to exercise….by the way, one of the unintended consequence of my hospital incarceration is that I have shed 9 kilos (goodbye Marie France, hello healthy living!). I intend to maintain, if not lose some more, but I will consult the Dietician who has been assigned to help me.

Manipulation of "frozen" shoulder

Because I have been through so many surgeries/physiotherapy, I have purchased a collection of “gadgets” (they don’t call me Ms Gadget for nothing, ok?) that I have brought to the hospital for my rehab:

Transcutaneous electrical nerve stimulation (TENS) for pain control

Ankle weight (above) and brace (below) for TKR Knee

7. Alternative Intervention

I am a believer of alternative intervention (aromatherapy, chiropractor, acupuncture, massages et al). My Indonesian maid of 13-years, Siti, is my personal masseuse who comes to the hospital everyday to massage the “angin – wind” away! By the way, her daughter in Indonesia is a trained nurse. I believe in the power of the human touch to heal. She also helps with physiotherapy and has been taught how to massage my frozen shoulder.

Aromatheraphy (Lamberger) - Courtesy of Irene

Enjoying a massage during home leave....but nothing beats the human touch!

I also incorporate music in my healing – to soothe my tired/battered body/mind and also to dance to….I have many CDs that I dance to when I do my exercises - to uplift my soul and also get the wind out!

8. Keep Your Mind Lucid

I needed a lucid mind to understand what’s going on and make my own medical decisions (my life is in my hands maaaa!) so I indulged in soduku, Code Breaker, crossword puzzles (fave mags: Australia’s New Idea and Woman’s Day).

9. A Positive Mind – Ability to Laugh At Yourself

This has greatly contributed to my healing. Yes, I cried and huffed and puffed, but when it was all over, I could joke about it…although believe me, it wasn’t funny when it happened (“and now when tears subside, I find it all so amusing, to think I did all that, and may I say not in a shy way, oh no, oh no, not me, I DID IT MY WAY…)” - 'Ole Blue Eyes.

Have brace...will travel

10. Little Things Mean A lot

HUKM is now home-away-from home! My mum complained to Siti that I am trying to pindah but mak…I am only trying to get well quickly so that I can later attend to your medical condition…..insya’allah mak, your doa will help me!

For those hot days/nights....

For those "hard-to-reach" places. Balinese back scratcher courtesy of Zia

Dental hygiene is important

So, there you go guys/gals....the secret to staying "young" - age does not matter as long as what matter does not age....in case you are wondering about "what matters", I am referring to the brain...gotcha!

Baby Nur Delisya Qaisara

She smiles....such innocence!

I first saw baby Nur Delisya Qaisara as a cute, little, bub snoozing in the nursery with a smile on her face. She looked so serene and she smiled occasionally – as if happy to be born. The nursery is located near the entrance of Wad Baldu so one cannot help but look in to see the babies enjoying their first hours or days of being born.

Looking at their tiny fingers with ‘lil white, nails, I am filled with awe at the power of the Creator. These ‘lil bubs were mostly well behaved – they did not bawl their heads off like some others born earlier.

The pure look of innocence on their faces evoked strong feelings of repulsion in me at the thought of abandoned babies…abandoned in trash cans, stuffed into bags and flushed down toilets. I wonder how two people called a man and woman could be so twisted that they are willing to sacrifice a life that never asked to be born.

As responsible citizens, it is our social responsibility to offer to help women who are pregnant out of wedlock. If they are Malaysians, I suggest they be referred to Women's Aid Organization, refer to my post dated May 31, 2009 on the subject of “Violence Against Women”. If they are foreigners (e.g your neighbour’s maid), report to their embassy and let them take over. You are not being “kaypochee” (busy body) if you intervene; you are being socially responsible.

To baby Delisya, Nan Nori say “welcome to this place called Earth”…it is imperfect, but we will try to make it a little better.

To proud first-time parents Azam and Awin….I wasn’t kidding when I said your lives have changed from the day of Delisya’s birth to at least 24 years down the road. But the joys of parenting will make the years seem to fly. Enjoy your ‘lil Lisya while you can!

Good luck Azam & Awin!

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

The Agony of Taking Blood

I could not sleep last night for fear of what’s awaiting today…taking blood. During my entire hospital stay, this is the MOST PAINFUL procedure because I have veins that are crooked (although I am straight as an arrow!).

I had the same problem at APSH and had to have a line inserted into the crook of my right arm. The needle had to be inserted in the OT (sterile environment) and I came to HUKM with the line. However, after many days, the line came off. Since I am now off all “encumbrances” – tubes, drainage bag, etc. – I am more mobile and this has greatly contributed to my recovery.

Today, I slept at 1 am and woke up at 5 am to await my horrible fate. The nurse first took my blood pressure and then….the moment of horror! They (2 nurses) started with my left hand and, after much slapping of my fist to find the vein, a needle is stuck.

Ya Allah, aku redha...walaupun sakitnya menikam diriku

Oh God! The pain was excruciating because although the needle went in, no blood could be sucked out……(i.e. the vein had burst). Since both my arms are bruised from needle marks, there aren’t many spots where a needle could be inserted.

Needle in...but no blood

They then moved to my right hand and found a rather unusual spot – the first knuckle which, by nature, is a very tender part of the hand. When the needle was pushed in, I screamed….and resisted…..making the process more difficult because I was tense. I was reminded to breathe in and out normally…I must have recited subhan’allah… subhan’allah…a hundred times. (Subhan'Allah سبحان الله) is an Arabic phrase often translated as "Glorious is Allah."

A rather sensitive site to poke a needle!

When it was all over, I was still sobbing in pain – physical and emotional pain!

Mak, I know now how you suffered when you had your chemo through dribs two years ago. We have the same genetic blueprint and I am sorry that I was impatient with you…in my heart, I thought you were just seeking attention and being difficult.

If you do not want anymore needle, I shall respect your wish…you (and I) have gone through enough pain!

Vincent

"Les Irises" by Vincent Van Gogh

"WHAT LIVES IN ART AND IS ETERNALLY LIVING IS FIRST OF ALL THE PAINTER AND THEN THE PAINTING" - Van Gogh

Just realized I have a Van Gogh reproduction (Les Irises) in my hospital room coz only now, my fuzzy brain is clearing up! This brings to mind a favorite song (Vincent - by Don McLean, remake by Josh Groben), which is a reflection of the torturous soul of a depressed person who was also suicidal.

Starry, starry, night, paint your palette blue and grey

Look out on a summer's day with eyes that know the darkness in my soul

Shadows on the hills, sketch the trees and the daffodils

Catch the breeze and the winter chills, in colors on the snowy linen land

Now I understand what you tried to say to me

How you suffered for your sanity

How you tried to set them free

They would not listen they did not know how

Perhaps they'll listen now

Starry starry night, flaming flowers that brightly blaze

Swirling clouds in violet haze reflect in Vincent's eyes of china blue

Colors changing hue, morning fields of amber grain

Weathered faces lined in pain are soothed beneath the artist's loving hand

Chorus:

For they could not love you, but still your love was true
And when no hope was left in sight, on that starry starry night
You took your life as lovers often do
But I could have told you, Vincent
This world was never meant for one as beautiful as you

Starry, starry night, portraits hung in empty halls
Frameless heads on nameless walls with eyes that watch the world and can't forget
Like the stranger that you've met, the ragged man in ragged clothes
The silver thorn of bloody rose, lie crushed and broken on the virgin snow

Now I think I know what you tried to say to me

How you suffered for your sanity
How you tried to set them free
They would not listen they're not listening still

Perhaps they never will.

A depressed person can identify with the lyrics; it speaks about a creative, sensitive, depressed individual with a tortured but beautiful soul - so tortured that he finally took his life at a young age of 37 (see an earlier post dated June2 on this subject).

My Crazy Friends!

This post is dedicated to my crazy friends, my Rock of Gibraltar (not THE ROCK, ok?) who have rallied to my side during these difficult times. We all have nicknames and I’ll tell you why.

Mastorah (Torah aka Ms Gorgeous). Golf Handicap 28

Anak mami Tanjong (“tak dak kereta merah, tak dah tiga ribu, jangan dekat anak Mami….biaq sampai reput”). Torah is married to Jim (golfer) who hails from Illinois (Obama country) and they are in KL on MM2H program (Malaysia My Second Home).

Ms Gorgeous likes to look good (don’t we all gals?), spends time working at gym (Michelle Obama, you have been warned!) and is an excellent cook. She is my Nutrionist-in-Chief, making sure I eat a healthy diet, etc. She kindly cooks soupy stuff and sends to my maid who brings them to me daily.

She is also into “sinful” cooking…her specialty – mee rebuih tanjong. And guess what the mee is called? – SODO MEE (la sodomie en français)! How did we come up with that name? Well, Irene is Indonesian (see below) and she is proud of their Indo Mie so in the spirit of Malaysia Boleh, we named ours SODO MEE and it’s really to-die-for. Also expert in making pulut urap and nasi ulam (so how to lose weight ah?).

Audi (real name Rotziyah, aka Mrs Bakar aka Ms Gelojoh). Golf Handicap 16

No, she does not drive an Audi although her dream car is Audi A4 (kereta merah no less). Married to Abu Bakar Sulaiman (Ash Burn) my kanda.

Audi is Chindian (Mamak Tongkang/Cina Apek crossbred), hence her looks. Sorry Di, but you told me your dad Mamak Tongkang, right?

Loves to eat (hence Ms Gelojoh) but does not put on weight because she lives on bread and stays off rice. How disgusting! I just have to smell food and I gain kg but I love rice mah!

She is a Montessori-trained teacher and she runs Cherish Kindergarten from home in Ampang Jaya (hello kawan, if you get students because of this blog, you know what I like to eat ok?). Audi speaks French as she lived in Mauritius for 3 years because Burn used to work for BBMB in Mauritius (pre-BMF scandal days, ok?).

Audi’s specialty is bruschetta (not French but Italian snack) and the “sinful” curry laksa. Audi, you know that everything I like is illegal, immoral, fattening and against the law, right? I can only try curry laksa next year lor….so scady-kat want to sek fan mah! But I aleady lost 9kg - begitulah hikmahnya....eat your heart out babe!

Audi is lactose intolerant (attributable, no doubt, to her Chinese blood) and does not eat beef and we almost pengsan when she threw up after eating es teler (Indonesian "ais kacang" equivalent) that contained milk although we had said no milk. This happened when we were celebrating my 55th birthday in Surabaya main golop in February 2007. Don't you dare pull one that on us again ok?

Mahani (aka Honey aka Ms Bumble Bee aka Ms Lembap aka Ms Calgary). Golf Handicap 30

Honey hails from the hospitality line (KDE, Park Royal) and is very laid-back, hence Ms. Lembap. Sorry Honey, sometimes you make my blood go upstairs especially when you so blur, like that night. I apologise for calling you and Audi “bodoh”…you know I was not myself, ok? But dun varry...I still loving you (remember the rock group Scorpian?). Honey’s specialty is mee hoon soto – also to die-for.

Honey is also related to me lah by marriage - her ex is my bro-in-law's nephew..."smell smell horse mango" lah (bau bau bacang!).

Irene (Rijanti) Desiderato (aka Ms Gangsta aka manquez gangster). Golf Handicap 28

Irene is Indonesian and is married to Alain Desiderato (golfer) who is French of Italian descent. They are also here on MM2H. Alain (who calls himself beruk kampung) is a Trainer with Schlumberger (orang minyak mah) and is a fun guy....like Inspector Jacques Clouseau of Pink Panther fame. Alain jet sets the world on business trips while Irene controls the purse strings....Le ministre des Finances, so lucky meh!

Irene is a no-nonsense person (hence Ms Gangsta) who once got out of her car with her daughter Shirley and directed traffic during traffic jam and guess what, the other drivers actually obeyed her. Seething with rage, she then asked the guy in the next for car for a ciggie (Irene, you really gangsta one lah, that guy must be shivering in his pants!).

The Desideratos are ardent scuba diving fans and they were caught diving somewhere when the tsunami hit!

Irene’s specialty is foigres (duck pate) and grilled salmon. Irene, lorsque vous revenez saumon grillé pour moi, oui?

Yours Truly (aka Ms Gabra aka Ms Gadget aka Cik Nori). Golf handicap was 30

but have not played for 6 months so while I will still carry 30, I guess my "standard" now will be 36. As a 36 handicapper, I once scored 42 stableford points at Kajang Hill and beat all the Royal Lake CLub single handicappers (males) to win. Gosh, that felt soooo good! After that, RLC golf convener Hari Prasad cut handicap lor!

At Bogor, I won prize on stroke play also so can cari makan lah. Also won at Kunming....I miss golf..boo.hoo!

Likes to dress up for golf (has 17 pairs of golf shoes of various colours, skorts, coloured balls...how I miss them). Goes my maxim "bior tak leh main asekan begaye" (looking good is half the battle won).

Also into all kind of golf gadgets (hence Ms Gadget) - pancing bola, ball finder spectacles, etc. Datuk Seri Yunus Tasi - I can play only next year lah!

Loves to swim, bowl, sing, golf. Always hyper (hence Ms Gabra) and cannot tolerate slowness/inertia. When excited, mouth moves faster than brain. Fun lover and inspires to sing/play piano ala Elton John but when mouth sings, hand stops, so I stick to singing only lah.

Known as Karaoke Queen at Exxon but mum who teaches quran reading said “kalaulah boleh baca Yasin alangkah baiknya”. I am trying mak....learning to read quran by CD and going to enrol in class by UIA ustaz when I am well. Hope to be able to read quran decently by the time I perform the Haj later this year, insya’allah! During last Umrah, I read Indonesian version of the Quran at Al Haram and was enlightened.

Loves R&B/black singers coz I have husky voice. Faves: "I Will Survive" (Gloria Gaynor), "Smooth Operator" (Sade), "Simply The Best" (Tina Turner), "Total Eclipse Of the Heart" (Bonnie Tyler), "Sweet Love" (Anita Baker),"Superwoman" (Karen White), Un-Break My Heart (Toni Braxton). Also do Broadway ("New York, New York" and "Mac The Knife)". Cannot sing Siti Nurhaliza songs cos I don't have that "lenggok - alunan" in my pitch.

Since my friends are such excellent cooks, very hard to lose weight lor ("not much fun left in life, don't deny me food; I'm on a seafood diet, I cannot see food, I eat 'em all). Has not cooked for 20 years (maid cooks) so my role in potluck parties is to provide dessert - give $ and Audi buys...fair enough, right?

Danny Deniro aka Batu King (Audie's bro).

Aiyah! cannot story you lah very complicated case one. You read on FaceBook lah. Golf handicap brapa bro - 2o?

So there you go, we enjoy each other's company for golf and other activities. They have been my strongest supporters during karaoke contests at Royal Lake Club although there were times when I kalah lah - sorry girls, but we did have fun didn't we? We are not fair weather friends as I am learning now.

Girls, looks like this old Gabra will be around for a while and you have to put up with me lor! Thank you gals for rallying behind me. "Don't go changin, to try and please me....I love you just the way you are - Billy Joel

Médecins Sans Frontières (Doctors Without Borders)

Médecins Sans Frontières or Doctors Without Borders, is a secular humanitarian aid non-governmental organization best known for its projects in war-torn regions and developing countries facing endemic disease.

Médecins Sans Frontières was created in 1971 by a small group of French doctors in the aftermath of the Biafra secession, who believed that all people have the right to medical care regardless of race, religion, creed or political affiliation, and that the needs of these people supersede respect for national borders. The initiators of Médecins Sans Frontières were:

1. Dr Marcel Delcourt
2. Dr Max Recamier
3. Dr Gérard Pigeon
4. Dr Bernard Kouchner
5. Dr Raymond Borel
6. Dr Jean Cabrol
7. Dr Vladan Radoman
8. Dr Jean-Michel Wild
9. Dr Pascal Greletty-Bosviel
10. Dr Jacques Bérés
11. Dr Gérard Illiouz
12. Philippe Bernier
13. Dr Xavier Emmanuell

The organization is known in most of the world by its French name or simply as MSF, but in the United States and Canada the name Doctors Without Borders is often used instead.

Core documents outlining MSF´s principles are the Charter and the Chantilly Principles, along with the later La Mancha Agreement, which in Rules, Section 2 addresses governance. MSF has an associative structure, where operational decisions are made, largely independently, by the 5 operational centres (Amsterdam, Barcelona, Brussels, Geneva and Paris). Common policies on core issues are coordinated by the International Council, in which each of the 19 sections (national offices) is represented. The International Council meets in Geneva, Switzerland, where the International Office, which coordinates international activities common to the operational centres, is also based.

In 2007 over 26,000, mostly local, doctors, nurses, and other medical professionals, logistical experts, water and sanitation engineers and administrators provided medical aid in over 60 countries. Private donors provide about 80% of the organization's funding, while governmental and corporate donations provide the rest, giving MSF an annual budget of approximately USD 400 million.

The organization actively provides health care and medical training to populations in more than 60 countries, and frequently insists on political responsibility in conflict zones such as Chechnya and Kosovo. Only once in its history, during the 1994 genocide in Rwanda, has the organisation called for military intervention. To be able to speak and act freely, MSF remains independent of any political, religious or economic powers. The majority of all MSF activities are paid for with private donations.

MSF received the 1999 Nobel Peace Prize in recognition of its members' continuous effort to provide medical care in acute crises, as well as raising international awareness of potential humanitarian disasters. Dr. James Orbinski, who was the president of the organization at the time, accepted the prize on behalf of MSF. Prior to this, MSF also received the 1996 Seoul Peace Prize. The current president of MSF is Dr. Christopher Fournier.

Talking about doctors and medicines, I am one who takes the trouble to research the Internet about my medical conditions (and I've had several, believe me).  I don't take what I read as Gospel but the info gives me some ideas on what questions to ask my doctors.  I also own a Readers Digest medical encyclopaedia that I refer to because I believe that patients heal faster if they actively cooperate with their doctors and to cooperate, they must have some idea about what's going on with their bodies!  

When I had a TKR (Total Knee Replacement) surgery many years ago, I subscribed to an online support group called Newbie Kneebies (new knees lah!) because there was such a dearth of information on TKR recovery. This site was started by a young lady who had so much problems with TKR and believe me, there are some gory stories in USA/Canada too (there were patients who were seriously considering amputation to stop the pain of recovery!). I also bought a book from Amazon.com titled "WHAT YOUR DOCTOR DOES NOT TELL YOU ABOUT TKR". This was written by an orthopaedic surgeon who had TKR and who now is on the other side of the pond - after that, he was able to empathise with TKR patients - because he had gone through and understood the pain they went through!

One of my favourite CNN anchor is the controversial Dr. Sanjay Gupta (I call him Brad Pitt with Brains... hopefully, he's also a competent neurosurgeon)!!!! I also subscribe to the controversial Michael Moore (of "Sicko" fame) group website and I learn alot from there. By the way, back at work, I was the company Medical Plan Administrator and I worked very closely with hospitals and insurers so I have some idea about what goes on behind the scenes.

I know there are doctors who show impatience with patients who asked too many questions; but patients have the right to know as much as possible about their condition.  If I come across such a doctor, I would tell him/her that (1) I have a right to know since it is my body; (2) I am paying for the bill; and (3) if I am not comfortable with the doctor treating me, I will find another doctor whom I am comfortable with!

Depression

Vincent VanGogh's Self Portrait

One of the most famous depressive personalities in history was the famed artist Vincent Van Gogh. The 19th century European society of Van Gogh's day was not ready to accept his truthful and emotionally morbid way of depicting his art subjects. His internal turbulence is clearly seen in most of his paintings, which set the stage for the direction of a new style of painting called Expressionism. It is characterized by the use of symbols and a style that expresses the artist's inner feelings about his subject.

Therefore, an understanding of the paintings by Van Gogh requires insight into his turbulent life, because his style of painting is exemplified by a projection of the painter's inner experience onto the canvas he paints. In Vincent Van Gogh's own words, he said, "What lives in art and is eternally living, is first of all the painter, and then the painting." To understand an artist of Expressionism we must first explore their biography.

Many of us can identify with the roadblocks that Vincent Van Gogh experienced in his many career and romantic pursuits, all ending in failure. His reaction to these experiences however, demonstrates a biological and psychological abnormality, causing behaviors that alienated those around him.

As he became more isolated from society and began to pour all of his energies into painting, his eccentricities and outbursts developed pathological traits, which caused him first, to be institutionalized, and second, it led to his suicidal death at the young age of 37.

During his short and turbulent life, he sold only 1 painting for 400 francs, just 4 months before his death. It is titled "The Red Vineyard" (See painting below). Nonetheless, he produced an incredible number of masterpieces that will continue "living" for the rest of human history.

Causes of Depression

Depression has no single cause; often, it results from a combination of things. You may have no idea why depression has struck you. Whatever its cause, depression is not just a state of mind. It is related to physical changes in the brain, and connected to an imbalance of a type of chemical that carries signals in your brain and nerves. These chemicals are called neurotransmitters.

Some of the more common factors involved in depression are:

1. 
   Family history. Genetics play an important part in depression. It can run in families for generations.
2. Trauma and stress. Things like financial problems, the breakup of a relationship, or the death of a loved one can bring on depression. You can become depressed after changes in your life, like starting a new job, graduating from school, or getting married.
3. Pessimistic personality. People who have low self-esteem and a negative outlook are at higher risk of becoming depressed. These traits may actually be caused by low-level depression (called dysthymia).
4. Physical conditions. Serious medical conditions like heart disease, cancer, and HIV can contribute to depression, partly because of the physical weakness and stress they bring on. Depression can make medical conditions worse, since it weakens the immune system and can make pain harder to bear. In some cases, depression can be caused by medications used to treat medical conditions.
5. Other psychological disorders. Anxiety disorders, eating disorders, schizophrenia, and (especially) substance abuse often appear along with depression.

Who Gets Depression?

Although depression can make you feel alone, statistics in America show that 16% of Americans will have it during their lifetime. While depression can affect anyone, its effect may vary depending on your age and gender.

1. 
   
   Women are almost twice as likely to become depressed as men. The higher risk may be due partly to hormonal changes brought on by puberty, menstruation, menopause, and pregnancy.
2. Men. Although their risk for depression is lower, men are more likely to go undiagnosed and less likely to seek help. They may show the typical symptoms of depression, but are more likely to be angry and hostile or to mask their condition with alcohol or drug abuse. Suicide is an especially serious risk for men with depression, who are four times more likely than women to kill themselves.
3. Elderly. Older people may lose loved ones and have to adjust to living alone. They may become physically ill and unable to be as active as they once were. These changes can all contribute to depression. Loved ones may attribute the signs of depression to the normal results of aging, and many older people are reluctant to talk about their symptoms. As a result, older people may not receive treatment for their depression.

Depression Basics

Some people say that depression feels like a black curtain of despair coming down over their lives. Many people feel like they have no energy and can't concentrate. Others feel irritable all the time for no apparent reason. The symptoms vary from person to person, but if you feel "down" for more than two weeks, and these feelings are interfering with your daily life, you may be clinically depressed.

Most people who have gone through one episode of depression will, sooner or later, have another one. You may begin to feel some of the symptoms of depression several weeks before you develop a full-blown episode of depression. Learning to recognize these early triggers or symptoms and working with your doctor will help to keep the depression from worsening.

Most people with depression never seek help, even though the majority will respond to treatment. Treating depression is especially important because it affects you, your family, and your work. Some people with depression try to harm themselves in the mistaken belief that how they are feeling will never change. Depression is a treatable illness.

Life with depression

Working with your doctor, you can learn to manage depression. You may have to try a few different medications to find the one that works best for you. Your doctor may also recommend that you see a therapist and/or make certain lifestyle changes.

Change won't come overnight—but with the right treatment, you can keep depression from overshadowing your life.

Help Someone You Love

When people are depressed, they're not the only ones who suffer. Typically, many of those around a depressed person—friends, family, and loved ones—also struggle with the effects of his or her condition.

Watching someone you love fight depression can be frustrating and frightening. Remember, you can't take responsibility for someone else, and the decision to get help is up to the person with depression. But, there are things you can do. For many people with depression, a friend or loved one who cares can be their most important resource.

What can I do?

1. Learn about depression—its causes, symptoms, and treatments. Knowing about the condition will help you better understand what a depressed person is going through.
2. Do what you can to make sure that a person with depression gets medical care. Encourage your friend or loved one to stick with his or her therapy or medication. Offer to go with him or her to appointments as support.
3. Be supportive and patient. Listen to what the depressed person has to say.
4. Without being pushy, encourage your friend or loved one to do the things that he or she used to enjoy. See friends. Go to the movies. Take a walk.

Emergencies

If someone you know is thinking about suicide, don't ignore it. Do whatever you can to get help for that person. Get in touch with his or her doctor or therapist.

Avoiding burnout

Helping a person with depression can be exhausting and overwhelming. Here are some things to keep in mind that can help both of you:

1. Try to get other people involved in helping a person who's depressed, since doing it on your own can be difficult.
2. People with depression often resist attempts to be helped. It's okay to feel angry and frustrated, but don't confuse the person you love with the illness.
3. Depression isn't anyone's fault. It isn't possible to “snap out of” depression.
4. No matter how overwhelmed you feel, take time for yourself.
   consult with your physician or healthcare professional before using any prescription product.

Modern Day Stressors on the Job

In today's globally-connected world where businesses operate 24/7 (in most multinationals, it is called "follow the sun" - i.e. when Asia shuts down, then virtual teams operate from elsewhere so that customers are always served), work-related depression is on the rise.

As an HR practitioner with 32+ years experience in a Fortune 500 oil and gas organization, I have seen many situations where this happens. In my own organisation, the flavor of the day is the Matrix Organization. In a Matrix Organization, the support services (HR, Purchasing, Law, Accounting, etc.) provide support to the revenue generators (in this case, oil exploration/production).

The revenue generators are, therefore, the "raison d'etre " (reason for being) of the service providers. It means that the revenue generators pay the salaries of the service providers and if it is not for them, the service providers would not exist. The support services have their functional bosses (usually located at HQ) but locally, they are accountable to the Country Manager who is the organisation's face in-country.

The challenge then becomes the "push/pull" between functional and country calls. The service provider is expected to manage the directives of two bosses and if these directives are at odds with each other, then he gets mired in a tangle - between his functional boss (who writes his appraisal) and the local boss (who pays his salary and whose input is sought for the appraisal). Therefore, in this role, conflict management and negotiation skills are of utmost importance, but they drain the employee's energy.

Another stressor is the borderless world we live in today is where, due to internet and broadband, the employee is always at the end of a phone line. Employees are on call and even if they get compensated, family life is disrupted. Then, because of time zone differences, some teleconferences take place at ungodly hours.

Yet another stressor (in large multinationals) is what we call the "home office" concept. As private corporations are bottom-line driven, the objective is always to be able to deliver the same service at lower cost than the nearest competitor. The "home office" is implemented for staff who do not need to be in the office to do their work - e.g. sales, hence saving on real estate costs. So, instead of fighting traffic jams to get to the office, the employee can just directly go to his customer which could be, in some instances, closer to his home. He goes into the office occasionally for meetings or to submit claims.

The employee is given the facilities of an office at home (which must meet certain local standards with regards to safety, etc.). A "home-based" employee faces certain challenges which may lead to depression. Feelings of isolation from colleagues must be managed and more importantly, the "out-of-sight-out-of-mind" syndrome is very real; for salary increases depends on your appraisal and if your boss does not see your face, maybe he has forgotten about you?

Also, in this situation, the line between work and family is blurred. Children (especially younger ones) are a challenge for if Papa is working in his sarong, then he must be on vacation. The employee, therefore, must be highly disciplined to manage the situation. Then, there are other social problems associated with the husband being left with a young maid - but I will not even get there.

During the current economic crunch, it is more stressful because employees fear for their jobs. Given the widespread incidence of work-related depression due to globalization, multinational companies must implement work-life balance programs and caregivers need to understand the workplace of today to appreciate what their patients are going through at work.

When Your Best Isn't Good Enough

So Susan Boyle, Britain’s Got Talent U-Tube Singing sensation came out second in the finals of last week. She lost to dance group Diversity. Today, she was taken to a London clinic following her “shock” defeat” at the contest because she actually got a standing ovation. "You had the nerve to come back here tonight, face your critics and beat them," judge Simon Cowell told her. "You did it."

Considering the circumstances and her background, Ms Boyle should be proud of her achievements. She’s just a simpleton out to have a good time (she hangs out at the local karaoke) and the intense media scrutiny was too much for her. She has finally woken to the enormity of the situation. She was even on the verge of giving up and had, at one time, almost packed up to leave.

But Ms Boyle had beat the odds and although she did not win the title, I believe doors are opening. I have been in enough singing contests to know that sometimes your best just isn’t enough. Remember James Ingram’s Just Once (“I did my best, but I guess my best wasn’t good enough”). There was even one contest where I was voted “Best Performer” but was not placed – didn’t make sense to me. But there are other factors other than just talent at play Ms Boyle, and you will learn.

And then there was one contest where I came out runner-up (National Panasonic 1997) and even beat Ms Adibah Nor (Yes, THE Adibah Nor who was not even placed). I was the oldest contestant at 42 while the youngest was 16. Adibah was then 24.

Adibah then went on to win the Bintang Harapan Nescafe talent contest which launched her singing career.

My point, Ms Boyle, is that winners sometimes don’t make it and “also rans” do better. Just see where Adibah Nor is today. As for yours truly? I am contented (except for hiccups here and there) and still singing the blues (sometimes, just kidding, more like syok sendiri in the bathroom).

But I have no regrets. I have nothing to prove – all I wanted was a good time and to see how competitive I was. I am a competitive person by nature and I sometimes push the envelope to see where I stand (be it skydiving, bowling, golf, or karaoke).

I like your fighting spirit in beating the odds, Ms. Boyle….you are my kind of person – you go girl but beware of the big, bad, world out there where you will soon find out they crawl out of the woodwork. Hire a good manager and keep a level head and don’t let fame get to your head – it’s a dog-eat-dog world out there!