Wednesday, November 28, 2018

THANK YOU, BLOOD DONORS!

I would like to record my utmost gratitude and most personal heartfelt thanks to the anonymous blood donors who helped my mom, who needed two transfusions yesterday. You are unsung heroes. For legal and medical ethical reasons, blood donors need to remain anonymous.

I’ve donated blood 56 times and have never received a blood transfusion myself. This is the closest I’ve been to knowing and feeling what its like to be on the receiving end.

I’ve only met one patient who indirectly benefited from one of my blood donations. She was a 12-year-old thalassemia patient who looked six. I had donated blood at Banting District Hospital and she came up to me to thank me. She said my blood type was not compatible with hers but because I made the donation, Banting District Hospital was able to exchange my blood for a compatible unit with Klang General Hospital. She must have been hanging around the blood bank for hours waiting for someone to make a donation and giver her a lifeline. I was touched. Sadly, I learnt a few months later, that she had passed on but I was glad to do whatever little I can to make her last days on this planet possible.

I would urge you to register as a blood donor, if you haven’t already done so. They are many benefits to being a blood donor, they are listed at the back of your donor card. Unfortunately, I lost mine after 38 years, a few weeks ago. I started donating blood long before it was a common thing to do, long before the National Blood Centre was set up, long before records were computerised. I’ve donated at GH KL, Pusat Darah Negara, Banting District Hospital, at Miri District Hospital, at Queen Elizabeth General Hospital, University Hospital and at University College Hospital in London.

You can donate whole blood, plasma or platelets. You can donate again only after three months of donating whole blood but as little as two weeks after donating plasma or platelets. Donating plasma or platelets take a lot longer than donating whole blood, though.

No, there’s no pain involved and it feels just like a prick. But blood donation is not for everyone. If you are below 1.52 m tall, weigh less than 45 kg, are anaemic, have hypotension, HIV, VD, hepatitis or any other of a myriad of contraindications, you are not eligible. You’ll have to contribute to humanity in some other way, hopefully through sweat, not tears. 

Copyright 2003-2018 Azlan Adnan. This blog post is sponsored by The Green Party of Malaysia

Sunday, November 04, 2018

ABOUT TIME WE ENFORCE ANTI-SMOKING LAWS

These bloody fools have been saying this same bloody toothless tiger nonsense for decades - the bloody stupid law exists already but the bloody stupid thing is...

NO ENFORCEMENT!

Who is suppose to enforce?

Restaurant owner?

Other diners?

Police?

Non-existent Health Inspectors?

Local Authorities?

Once the cabinet has decided, wake me up, okay.

Until then, pundek lah...

NATO. NO ACTION TALK TALK TALK ONLY...

https://thecoverage.my/news/lim-guan-eng-government-will-not-allow-smokers-light-restaurants-fined-rm10000-jailed-2-years




Copyright 2003-2011 Azlan Adnan Legal Notice Copyright 2003-2011 Azlan Adnan. This blog post is sponsored by The Green Party of Malaysia

Saturday, November 03, 2018

Thoughts on Diabetes

Thinking Out Aloud about Diabetes 

I just want to sound out if my understanding of diabetes is correct, so please correct me if my understanding is incorrect, so that I can learn. Understanding what’s going on, cures you. Because the correct understanding empowers and motivates you to make the necessary lifestyle changes. Diabetes, after all, is a lifestyle disease.

Pancreas
There are cells called the islets of Langerhans in the pancreas that produces insulin. These cells constitute only 1% of the cells in the pancreas. The other 99% of the cells produce various digestive enzymes for you to digest various foods.

Pancreatic Cancer
Patients with pancreatic cancer have a very grim prognosis. The survival rate at 5 years is 9% and at 10 years is 1%. There has been very little progress in the treatment of patients since World War II, or at least in the past 40 years. The main treatment modality is radiotherapy.

Patients have a low survival rate because without digestive enzymes, they are unable to metabolise the food they eat, starving all their cells, tissues, organs and muscles of nutrition. Its a very systemic shutdown of the whole human body.

Type 1 Diabetes 
This is usually diagnosed in childhood or in the teens. Most patients have some genetic make-up that causes their pancreas to be unable to produce insulin at all, or only in very small amounts.

Type 1.5 Diabetes 
I’ve heard this term used, but am unsure what it means.

Type 2 Diabetes 
This used to be called adult onset diabetes. In these patients, their blood glucose levels are high and there can be many different causes. That is why some experts say that there are actually between 47-50 different types of diabetes, depending on what particular aetiology is responsible for the high blood glucose.

In patients who cannot produce  insulin at all, they have to take insulin artificially, usually by injection; the route of administration may be subcutaneous, intramuscular, intravenous. If they can produce insulin, but only in insufficient amounts, two treatment modalities are usually employed:

a) insulin injections
b) medications (such as gliclazide and metformin). They work in various ways. Some meds may cause the pancreas to increase production of insulin, others work by forcing the cells to uptake glucose from the blood. Yet others work by removing the excess glucose in the blood by excreting it in the urine, hence the Malay name for diabetes, “kencing manis” - sweet urine. In the old days, people with diabetes would notice that ants would go hurong their urine. 

Type 3 Diabetes 
I’ve heard this term used to mean “diabetes of the brain,” but again, I am unsure exactly what it means.

Insulin
Insulin is a hormone produced by the islets of Langerhans in the pancreas. It has a half-life of only 4 to 7 minutes. Its production is triggered by eating carbohydrates. So, counter-intuitively, if your pancreas is still able to produce insulin, you need to eat some (a little) carbohydrate to trigger the production of insulin. The exact amount differs from person to person and also on your state or condition.

In layman’s terms, the best analogy is to think of insulin as a key. Insulin binds with the receptor site (think of it as a keyhole) on the surface of your cells. When your cells require energy, it signals insulin to come to the keyhole to unlock the door that allows glucose to enter your cells.

Carbohydrates
This is an umbrella term for both starches and sugars. Laymen usually use it to refer specifically to starches, though, not to sugars. However, medically trained people use the term carbohydrate to collectively refer to both starches and sugars. This can sometimes lead to misunderstandings.

Saccharides, polysaccharides, oligosaccharides
These terms are used in biochemistry to refer to various types of sugar. The simplest form of sugar is called glucose. All starches, all other types of complex sugars are broken down to glucose in the digestive process. Glucose is what is required by your muscles to make them contract. Basically, we metabolise glucose to create energy. I don’t quite understand the exact process but it involves a chemical called ATP - adenosine triphosphate (ATP) is a complex organic chemical that provides energy to drive many processes in living cells, e.g. muscle contraction, nerve impulse propagation, chemical synthesis. Fructose is fruit sugar, sucrose is cane sugar. Usually, chemicals ending with “-ose” is some kind of sugar, i.e. galactose, lactose (milk sugar), maltose, and etc.

Starches
Also known as complex carbohydrates. These are long chains of molecules, structurally bound with cellulose (aka dietary fibre) that slowly get digested to eventually become glucose. The whole idea is to eat complex carbohydrates rather than glucose or simple sugars such as sucrose or fructose so that our bodies are “drip fed” with small amounts of glucose over time as our digestive process breaks down these complex carbohydrates. As opposed to getting a “sugar rush” or spike in blood glucose by consuming a lot of simple sugars in one go.

Glucose Transfer Factor and Chromium
Glucose Transfer Factor (GTF) is a complex chemical that functions in assisting glucose through the doorway into the cells. At its core is the trace element chromium. Chromium is usually regarded as a heavy metal, and indeed, large amounts of it can cause toxicity. We require trace amounts of it for our GFT. MLM distributors are very gung ho in recommending chromium whenever they hear of anyone just been diagnosed with diabetes (their eyes light up as they see “hot prospect” so that they can kena you properly).

Guardian, Caring and Alpro have all stopped selling chromium tablets. Why? You only need trace amounts and if you eat enough whole fruits and leady vegetables daily, you will have sufficient chromium.

No need to spend RM100 buying chromium picolinate because its supposedly much better than other forms of chromium. You only need 200 micrograms (mcg) daily, not even milligrams (mg). Just spend a few dollars eating sayur lah.

Actually, you can get almost all your nutritional needs from the plant kingdom; the only stuff you need that you can only get from the animal kingdom are what are called essential amino acids. These are essential building blocks to produce protein that the human body cannot synthesise and is not available from the plant kingdom.

That is the conventional wisdom anyway and vegans and vegetarians dispute this. They point to the elephant, the largest animal in the jungle, so big and muscular, so much protein. Yet, I have never met an elephant that has eaten a single steak in its life. Have you?

Something to think about, yeah...

Lipoprotein
This is an umbrella term to cover lipids, oils, fats, fatty acids, triglycerides and the like.

Insulin Resistance
This term refers to the inability our cells to utilise insulin to unlock the door through which glucose can enter the cells. The main cause is lipoprotein overload. This simply means that we have too much lipoproteins. This excess lipoproteins block the keyhole (insulin receptor site) on the surface of our cells. Which means insulin cannot go into the keyhole to unlock the door which allows glucose to enter the cells.

Insulin resistance usually refers to patients who can produce sufficient amounts of insulin but the cells cannot use it to unlock the glucose door. For these patients, taking meds in the long term is problematic as the meds force insulin production to go into hyperdrive, leading to complications down the road. Logically, it would seem better to clean out the blockages in the keyhole in the first place, i.e. get rid of the excess lipoproteins.

“How?” you may well ask
Go on the 70-15-15 INSULIN RESISTANCE REVERSAL DIET. This diet is not suitable for all diabetic patients. Firstly, your body needs to be producing sufficient amounts of insulin in the first place. Usually, these patients with insulin resistance can produce sufficient insulin; its just that excess lipoproteins block it from doing its work. However, patients on insulin have also benefited in that they can reduce their insulin dose, as their insulin keyholes get unblocked. If your body can produce sufficient insulin in the first place, you only need go on this diet for 90 days; this would be sufficient time to get rid of the excess lipoproteins that has been blocking the insulin receptor sites.

But you need to do this under medical supervision, preferably in consultation with a dietician as well. You need to monitor five biomarkers, PILAF:

P - (Blood) Pressure (every other day)
I - Ideal Body Weight (how far are you from it?)
L - Lipoprotein Profile (every three months)
A - (Hb)A1c (every three months)
F - Fasting Blood Glucose (weekly is sufficient)

More about this diet at:
www.masteringdiabetes.org

Another credible and authoritative source of information about diabetes by the world’s leading experts and researchers that I highly recommend is:

www.coursera.org/learn/diabetes-essential-facts

Reminder
Please do not make a friend request unless we’ve met and I know you in real life as I routinely block people whom I have no idea who they are. I prefer to answer questions publicly either here or any of the pages I administer so that others may benefit, too, from the discussion. I am not a physician and am not in the business of giving medical advice so please do not message me. I am a fellow patient, just like you, on this same journey together. I can only speak from my own personal experience (read anecdotal evidence with a sample of one) and from what I’ve read and learnt. We really need to invest the time to educate ourselves about our health because we, as patients, need to be accountable and responsible for our own health - we cannot simply abdicate this responsibility to our healthcare providers.



Copyright 2003-2011 Azlan Adnan Legal Notice Copyright 2003-2011 Azlan Adnan. This blog post is sponsored by The Green Party of Malaysia

Tax on Sugared Water

TAX ON SUGAR WATER

I already wrote about this on August 27. Instead of being pro-active and doing scenario planning, contingency plans, and etc., many corporations I have spoken to told me they have not received any official word and simply adopt a “wait and see” attitude. 

Well, now you have official word and your wait is over. Selamat berkial-kial, mofos...

https://says.com/my/news/budget2019-government-to-introduce-tax-on-sugary-drinks-from-april-2019

My piece of Aug 27:
http://azlanadnan.blogspot.com/2018/08/soda-tax.html

Bila nak terberak baru nak cari changkol gali lobang...

I welcome suggestions from diabetics on how the 40 sen tax should be spent on to improve our quality of life. I’ll compile your suggestions and sent it as an open letter to:

YB Dr Dzulkefly Ahmad
Minister of Health Malaysia
Ministry of Health
Block E1, E3 , E6 , E7 & E10, Parcel E
Federal Government Administration Centre
62590 PUTRAJAYA
Malaysia
Phone No: 03-8883 2527
Email: drdzul@moh.gov.my 

I first met YB Dr Dzul six and a half years ago, he is on the extreme left in this video:
https://youtu.be/RcLZoCFIN3A

If you want to write to him directly, please feel free to do so. The more people write, the more our voice will be heard.

For example, I visited both Klinik Kesihatan Kota Damansara and Klinik Kesihatan Kelana Jaya earlier this week. There is so much room for improvement...

Some notes about the state of public healthcare in Malaysia. 

I live in Kampung Sungai Kayu Ara, within the catchment area of Klinik Kesihatan Kelana Jaya, which has a pathology lab. The earliest date I can get to check my HbA1c, lipoprotein profile, uric acid, and etc is in Feb 2019. I can only get the results a month later. The results will be handwritten as the clinic does not have a printer.
https://goo.gl/maps/77ctvwpbVoq

There is a Community Clinic (previously known as Klinik 1Malaysia) within walking distance to my place. They can only do FBG and BP. Even then, the MA says they get sent only 15-20 test strips a time, and frequently run out.
https://goo.gl/maps/SQPRRtniesT2

Klinik Kesihatan Kota Damansara is even more horrific. Two MOs share an examination room. They sit on desks pushed against each other and sit facing each other. You tell your medical problems to the MO attending to you whilst another patient does the same to the other MO within earshot of you, although you sit back to back.
https://goo.gl/maps/82Df5DiBxXm

There is no pathology lab in Klinik Kesihatan Kota Damansara; all specimens are sent to the pathology lab at Klinik Kesihatan Kelana Jaya and it typically takes three weeks to get your results back. I neglected to inquire if they have a printer.

If you think there is room for improvement, please lobby your MP to vote for a bigger budget for healthcare and less on military spending. We, the Rakyat, need to make our voices heard for change to happen. Change doesn’t happen spontaneously without a call to action.

In Latvia, sugared drinks are banned altogether - no cordials like Ribena, SunQuick sold in supermarkets or wherever. Fruit juices are not permitted to contain added sugar, just pure fruit juice. Soft drinks like Coke need to be zero calories, only with non-calorific sweeteners.

On all my visits to Riga and Jūrmala, I noticed the girls are all svelte, slim and look like ballerinas. Now you know why I go to Latvia every summer...

https://youtu.be/k8pb0aSJMhg

Copyright 2003-2018 Azlan Adnan. This blog post is sponsored by The Green Party of Malaysia