hypertension

hypertension = high blood pressure, probably the most common cardiovascular disease in our society. it involves abnormal pressure documented within our vessel wall itself due to several factors. most often it is due to unhealthy diet, causing thickening of vessel wall and accumulation of fat along the wall. this lead to unhealthy vessel wall and the blood vessel became less elastic, making the heart to pump higher pressure to exert desired effect. these thickened vessels are quite fragile and easy to break when the pressure is too high, thus making the control of the blood pressure very important.

initially we need at least 2 blood pressure reading on 2 different circumstances higher than normal value to diagnose a patient to have high blood pressure. on first high reading, we advise patients to modify their diet and lifestyles, encouraging them to do more exercises and screen for high cholesterol status. when the blood pressure is persistently high despite all these are done, then the role of medication came into play. in government sector, at least 5 different groups of antihypertensive medicine (medicine for high blood pressure) are available to our population. which group to use or what combination to use would vary among patients' age group and health condition.

unlike some patients' belief, oral antihypertensive treatment is lifelong treatment once it is started. so, we do not cure hypertension, but we control it with medication. with medication, patients achieved optimal control of pressure, and therefore reduce the risk for cerebrovascular event (stroke), heart disease (heart attack) or impaired renal function (kidney function)

important aspect in controlling high blood pressure would patients' cooperation in taking medication as advised by doctors, healthy lifestyle (daily) and balanced diet. smoking is proven to worsen high blood pressure control and also lead to many other diseases. the steps mentioned are not difficult to be done, but often is the most difficult to be maintain by patients throughout life.

life is never meant to be easy

although i already realize the truth, but events happening around keep on reminding me that life is never easy. probably it was never meant to be. maybe it supposed to be challenging, most of the time we will feel defeated, depressed and always sit in one place with despair, but eventually the only right thing to do is to get back up and move forward to more difficulties in life. am i being pessimistic? maybe, but tht may as well be the truth. like my bro said, plan too much, u'll get nothing achieved. s/times we just have to do things step by step. speculate only some time n portion of near future. things happen and ppl change, so a long detailed plan may possibly cant be carried out as we expect it would.

not so long ago, we have the excitement of planning our future: together and aspiring each other's work and future career, with nice imagination of having small but sweet and warm family together. we thought we have good chance to work together again, just like last time during housemanship. but an offer letter assigned him to a new psy hospital in his hometown. this apparently is a better option for him, n without doubt, supported him to go there to work. it would be better for his postgraduate programme. but also at the same time, i have decided to pursue my part of career in my current hospital, most likely working towards postgraduate programme as well. with such twist of event, i can already foresee at least another few years we will be working in different district, striving hard for further success. but scene of having a home together seem so much dimmer now. i cant denied i have mixed feelings, which at some moments i dunno how to handle them except keeping quiet. it is the best choice we have, but probably marriage will be a bit difficutl up ahead. i'm not confident in distance r/ship even it is only 60 km away.
we will be only meeting up over weekends when not on call, probably one or two nice dinner together per week, n half our meetings will be together with his relatives. i'll have to handle my stress from work myself and alone most of the time, with maybe ventilation to him through only phone calls, not accompaniment. my video game and laptop will still be my loyal companions within the four walls of my room. friends, sure i have quite a number here. but the one i want to be with the most, he is not there half the time.
condition may as well worsen when we both become specialists. being in govt sector where medical staffs are always severely in shortage, we would most likely get assigned to different districts to serve the public better. children, another major factor to consider. how can i be confident to raise my own offspring without firm stable home for them? i'm not sure. currently i feel doubt, not about my work as a doctor, but my future as a person. helps and advices are always within calls and steps away, but there are things i think that i have to think through myself
despite all these troubling my mind at more n more frequent intervals, there are times i regretted to get into relationship. it is an emotion wanting to escape from reality, but eventually i realize i'm still glad that i came to know him.
problems will undoubtly be solved eventually. the point is i have to find the solution in time and try not to ruin what i hold dear.

influenza A

since SARS, nipah and bird flu, yet again we face treat for having possible pandemic disease throughout our world. it wasnt tht long tht malaysia got the first infected patient since the outbreak in mexico. as fas as i undrstand we have yet to develop any vaccine to this newly mutated virus. i do hope my family in KL are ok and hoping for the best for my brother working abroad in singapore. personal hygiene and frequent hand washing is important. if possible, kindly avoid crowded places to reduce chance of getting infected. mom, maybe cooking at home would be good option for u there in KL. :)
crossing my fingers, hope all these will be under control soon.
confirmed cases reported in hospital sg buloh, Penang GH, and treated patients in GHKL. not very good chance for hospital taiping, i think. :P

hydrocephalus

my bro implied maybe i should say s/thing about medical stuff a bit, n since my memory still fresh after attending the synapse course, i'll talk abit on hydrocephalus.

Hydrocephalus literally means (in Greek) 'water+head'. n sometimes u may heard ppl having babies with big head, with lots of water inside. in medical terms, it means active distension of ventricles in the brain with collection of CSF inside. ventricles are spaces inside the brain which are important for good flow and drainage of brain fluid. CSF stands cerebrospinal fluid, means brain fluid which is comminucated into down the spine via the ventricles and blood vessels. all normal ppl have normal size of these spaces. we have place inside the brain that produce this brain fluid and we have natural perfect drainage system to drain them outside the narrow place of our skull into our blood vessel eventually.

what can happen is a number of events can take place and cause this drainage system goes wrong. either the development of the brain during fetus is not normal, infection or tumor inside the brain cause obstruction to happen and therefore the brain fluid was kept producing but not drained adequately. with no else where to go, the spaces inside the brain (ventricles) will be dilated (swollen, distended, etc) so therefore the term ' water inside the head'. Neurosurgical experts will further grade the condition into truely obstructing or communicating hydrocephalus. but generally, babies with hydrocephalus need to be treated with, most if not all, surgical intervention. we will try to identify and remove the cause if possible. if the hydrocephalus is mild and the brain was not being compressed, we can monitor and see first. if the cause cannot be removed, then we aim to divert the brain fluid flow away to some other place where it can be drained properly. n hence u heard ppl doing 'shunts' or 'tube' or 'pipe' inside the head.

some of the important questions ppl concern: will my baby intelligent? function impaired? able to walk? etc etc. this really depend on the condition of the brain when we saw the film and examine the babies. IQ may be affected, movement may also be questionable if part of the brain being compressed is related to that function, life span of the babies affected vary depending on what events they undergo later (eg: surgery, disease, infection, long hospital stay, rehabilitation program etc etc...) but hey, nothing in medical is for sure and there's no 100% accurate answer. we have example of a child who had a shunt inserted for hydrocephalus going to normal school and score in academy. provided with background of our society, i think no parents would give up on their children who has hydrocephalus. what is important is we need close follow up with these patients and provide support as needed.

back to taiping...

i have spent good amount of time at home in KL, as long as 6 days. mwuahahaha.... n bought a couple of new game for my PS 2 but unfortunately one of them can be only played using newer version of PS 2 (which my sis has it...)

next i attended the Synapse II in Hospital Ipoh organized by neurosurgical department. would say that i learnt some good knowledge about brain pathology although only guidelines in management, furnished by high technology exposure from famous neurosurgeons from around the country. think medical field is doing better in producing more n more specialised consultants and surgeons. :D

once i'm back to taiping today, i have another half day extra. so i went to settle my application for MRCS exam. plan to attend the exam in september in KL... but my god, isnt the fee expensive... spent almost 1.5k on a bank draft, n becoz i dun feel secured mailing it to UK with just pos laju, i used a courier to send it, which also cost me a fortune... argh... i have to push myself hard to pass this exam. ;P

might take the eve abit more relax, then start working in books tomorrow. ;O