angioplasty

when is it considered too young to undergo angioplasty and be fitted with 2 stents?

before your 36th birthday?

wilson did an angiogram today and was given a choice between angioplasty and a bypass operation. guess it's a no-brainer... at least for the time being. i knew i was dealt the short end of the stick with regards to pre-disposition to heart diseases years ago. my mum had her bypass operation in her 40s while my dad had angioplasty and stenting done in his 50s.

that made me take my health very seriously. the scene of my mum in the icu ward after her operation was indelible. her lying immobile with many tubes and electrodes connected to various monitors made me realise how fragile life can be and i resolved that i will not want to be in the same position.

my dad's subsequent heart attack in the middle of the night reinforced the necessity of a healthy lifestyle. something that i took to heart (pun unintended). however, both events appeared so distant now and our daily diets are not as 'healthy' as can be since my parents are now under medication with regular followups.

i suppose wilson's procedure today is a wake-up call for all of us that we need to be mindful of our diet as well as to exercise regularly. at least estee is now cognisant that she can't continue with her sedentary and meat-loving lifestyle.

me? i shudder to imagine putting a catheter through a vein in my wrist to reach the arteries in my heart. just the thought makes my spine tingle and knees kind of soft so i guess my motivation will be to avoid such a situation.

you can call me a coward for that and i wouldn't mind a single bit. :)

photo credit: http://www.britannica.com

limp, limp

Gout and Hyperuricemia At A Glance

•Painful gouty arthritis is caused by uric-acid-crystal deposits in joint tissue.

•Gout is a chronic, progressive disease.

•The tendency to develop gout and elevated blood uric acid level (hyperuricemia) is often inherited.

•Gout and hyperuricemia are aggravated by obesity, weight gain, alcohol intake, high blood pressure, fructose in corn syrup found in soft drinks, abnormal kidney function, and certain medications.

•Gouty arthritis attacks can be precipitated by dehydration, injury, fever, heavy eating, heavy alcohol consumption, and recent trauma or surgery.

•The most reliable diagnostic test for gout is the identification of crystals in joints, body fluids, and tissues.

•The treatment of an attack of gouty arthritis is different than the treatment of hyperuricemia. There are two key concepts essential to treating gout. First, it is critical to stop acute inflammation of joints affected by gouty arthritis. Second, it is important to address the long-term management of the gout disease in order to prevent future gout arthritis attacks and shrink gouty tophi crystal deposits.

credit: medicinenet.com

episode 2

return of the gout. :(

had a bad feeling when i went out for breakfast with my sis today. already felt my right toe was out-of-sorts yesterday during yoga class but i thought and hoped that it was just my imagination. apparently, my imagination isn't not fertile. sigh...

the condition got worse throughout the day until i had to take a painkiller before i can go to bed.

ouch!

national cancer centre

didn't know that cgh actually makes appointment for its patients to visit the national cancer centre for consultations. they actually send my 二舅there accompanied by a nurse for his appointment. My mum and i went along to see what the oncologist have to say.

after evaluating 二舅's case. the oncologist decided against chemotherapy as he thinks that 二舅will not be able to withstand the toll the treatment will take on his body. he's concerned that chemo will hugely compromise 二舅's immunity system making him highly susceptible to infections.

next, we had to see the radio-oncologist who decided on a 7-week course of radiotherapy that has a 40% chance of eradicating the tumour in 二舅's throat. the treatment will only start next month after some prep work such as getting a face mask done. meanwhile 二舅will continue with his liquid diet since the therapy will also impair his swallowing ability in the short term.

and that's how we spent almost the entire day at the centre.

journey to the east

another visit to cgh to see my 二舅. he has been warded for 2 weeks already and put in isolation in bed 1 at ward 36 'cos they suspect that he might be suffering from tuberculosis. his difficulty in swallowing has been attributed to malignant tumours in his throat.

we had to put on n95 masks to see him in his room. according to the instructions at the door, we even need to be gowned and gloved but we didn't bother with it except to sanitise our hands with care before and after visiting him.

the nurse came in after a while to feed him. i was asked to explain to 二舅 that she will change the feeding tube after the feed as the current one is meant for 2 weeks only. so my mum and i waited... and waited...

the nurse gave up and undrew the curtain seeking our help to tell 二舅 to swallow [in teochew] when she's inserting the feeding tube through his nostril. i think the gag reflex somehow interfered with the insertion and the tube kept looping out into his mouth instead of getting into his stomach. not a pretty sight.

then she got 二舅 to sit up after several failed attempts on the right nostril and decided to insert the new tube onto the same [left] nostril. with much retching and our promptings of "吞", sections of the tube were painstakingly inserted until the nurse estimated that it has reached the stomach. she confirmed that by aspirating some fluid with a syringe.

finally some relief for my 二舅.

you can see how it's done here.

painfully alive

sharp tummy-ache at 1:00 am... weren't awoken by the pain but had to disrupt my online activities. :P

it was the most excruciatingly painful ordeal that i've ever experienced. the pain was searingly acute that i broke out in cold sweat so profuse that my tee was soaked thoroughly. i thought i was going to faint even.

and i wonder how does this compare with labour pains? janet says that it's very painful. but how painful is that?

a taiwanese artiste described the pain level during labour as akin to cutting off one's fingertips so labour pains are like repeatedly cutting off one's fingertips. arrgghhh...

faint...

masked

this is not the latest fashion. but it's the first time ever that i've donned a mask all thanks to the global pandemic of h1n1. so it's a momentous occasion worthy of some digital pixels. :P

had went to visit my 二舅 at cgh. i heard he was hospitalised 'cos he wasn't eating well and had trouble swallowing. as usual, since he was just warded today, they have to run tests on him before we know what's ailing him.

he looks fine except for the tube in his nostril meant for tube feeding. hope he gets well soon.

cheers!

g6pd

deficiency of the enzyme glucose-6-phosphate dehydrogenase (g-6-pd) is an inherited abnormality which may provoke the sudden destruction of red blood cells leading to some very undesirable consequences because this enzyme is essential for ensuring a normal life span for red blood cells and for oxidising purpose.

guess who i know has this deficiency? ;)

dear eric who is hospitalised at sgh now has it.

something that i found out today. he was up and chatting with his sister when i arrived. from what i know, his blood pressure is still elevated although x-ray has shown his pneumonia to be improving. 2 ultrasound scans have also indicated normal-sized kidneys which is reassuring.

he complained about the potassium chloride solution iv which he likened to a hard, stinging pinch. having had 2 dialysis sessions so far, with the 3rd one re-scheduled, he's up for a kidney biopsy tomorrow. hopefully, that will provide more insight into what's ailing him.

before i left, i passed eric something to keep him occupied. :P

let's hope he gets well soon.


* g6pd deficiency information from www.g6pd.org

eric's down

received an sms from jeffrey this morning saying that eric is hospitalised and had to have dialysis. gosh! this sounds so serious...

going to visit him later at sgh to find out more.

weekend warrior

my 2nd 'mishap' during my days of self-declared vacation, i sprained my ankle while playing tennis with some friends.

i twisted my left ankle too much until it gave way. momentarily unsupported, i fell on my right bum. at that time, the fall hurt more than the sprained ankle.

but as the day went on, the swell became worse and i was limping around as if i had another gout attack.

ouch!

gouty arthritis

yup, it's confirmed that the swollen toe joint that i had last week was due to high uric acid level in my blood. the blood test had returned a result of 8.9 mg/dL, quite a bit higher than the normal range of 3.4 to 7.0 mg/dL.

right now, the gp has recommended dietary control to see if the uric acid level can be kept in check. basically it is to avoid purine-rich food and to stay well-hydrated at all times.

additionally, exercise will also help to metabolise the uric acid. that means that i should get back onto my usual workout routine since i've more time now. :P

will do a follow-up blood test in 2 month's time to monitor if there's any improvement. if it falls within the normal range, then medication is not required.

cheers to good health in 2008!

ouch

limped to see the gp at the next block this morning.

my first toe joint is swollen and it has progressively gotten worse from the first signs of trouble on wednesday. it wasn't some gungho injury from sports or gym. neither was it a result of a swipe at an offending furniture in the dark at home.

so what happened?

i couldn't remember any trauma to the right foot. with all external factors eliminated, it only left me with the dreaded 4-letter 'g' word - gout.

a condition that results from crystals of uric acid depositing in tissues of the body. it is characterised by an overload of uric acid in the body and recurring attacks of joint inflammation. info from here.

how do i know about this condition? well, johann has it and had described the symptoms to me previously. just that i didn't know it can be SO painful.

and i can't remember how many times i've cursed under my breath when trying to move my right foot even a tiny fraction of an inch. yes, it has become so sensitive that even the slightest movement is traumatic not to mention touching it.

my foot became so tender and painful that putting it under my quilt is unbearable. needless to say, sleep was affected.

that was how i ended at the vista family clinic this morning. i would have been here last night had it been opened.

just as expected, the gp's diagnosis confirmed my suspicions. had a blood test to check my uric acid level, the result will be out tomorrow. meanwhile, anti-inflammatory medication and painkillers were prescribed together with advice to stay hydrated and a list of food to abstain and avoid.

btw, johann was spot-on when he said the elderly uncle was streaking ahead of him while he was shuffling along miserably the time he had an attack.

it happened to me too. :(