THE retina is a transparent layer at the back of the eye that receives visual information and converts it to electrical impulses which is transmitted to the brain via the optic nerve.

The retina is analogous to the film at the back of a traditional film-based camera. The blood supply of the retina is predominantly the central retinal artery while the blood flows out via the central retinal vein. Both these blood vessels travel along the optic nerve, which is located at the back of the eye.

Retinal vein occlusion (RVO) is a common cause of painless visual loss that occurs suddenly and can lead to severe loss of vision.

It occurs in about 0.5% of the population, so in Malaysia, it is estimated that more than 100,000 people will have this problem. It is more common in patients above the age of 50 years.

There are two main types of RVO - central retinal vein occlusion (CRVO) and branch retinal vein occlusion (BRVO). BRVO is twice more common than CRVO. Visual loss occurs due to swelling in the macula (macula oedema), which occurs in both these types of RVO.

The macula is the most important part of the retina as it detects very fine detail and colour and any damage to it will cause reduction in our vision.

What Causes Retinal Vein Occlusion?

RVO occurs due to blockage of the vein. This usually happens when the retinal veins are compressed by the retinal artery next to it. Like all arteries in the body, the retinal artery naturally thickens with age, especially if we have diseases like hypertension and high cholesterol levels in our blood.

This thickening of the retinal artery causes narrowing of the retinal vein which is usually located next to the artery. There is reduction of blood flow in the retinal vein leading to blood clot formation and finally total blockage of the vein.

When the retinal vein is blocked, the pressure within the vein increases, causing leakage of blood and fluid out into the retina.

The retina also becomes starved of oxygen (ischaemic) and there is an increase in the levels of a growth factor called vascular endothelial growth factor (VEGF). VEGF causes further leakage of fluid from the blood vessels and increases macula oedema.

Sometimes, there is growth of abnormal new blood vessels on the surface of the retina. These blood vessels are fragile and easily bleed into the eye.

These blood vessels can also grow in the front of the eye on the pupil and can bleed and cause raised eye pressure.

This can be very painful and difficult to treat.

What Are The Risk Factors For Retinal Vein Occlusion?

There are several major risk factors for developing RVO. These are: high blood pressure, high levels of serum cholesterol, diabetes, and glaucoma. For patients younger than 50 years old, they often have blood clotting diseases like high serum homocysteine and antiphospholipid syndrome.

In females, the use of the oral contraceptive pill is associated with a higher risk of RVO.

Patients who develop CRVO tend to do badly without any treatment. Only 20% of patients have an improvement of vision without treatment.

Most patients (80%) lose significant amounts of their vision with this condition and a large percentage of untreated eyes can also develop glaucoma and bleeding in the eye.

BRVO has a better prognosis than CRVO as the patient’s vision is usually not as badly affected. If there is macula oedema present, the visual acuity does improve with treatment. Less than 1% of patients will develop bleeding in the eye in BRVO.

In a few large population studies like the Beijing Eye Study, RVO was associated with a significantly increased risk of death from cardiovascular disease. Men who developed RVO had a two times increased risk of developing stroke.

As such, when a patient develops RVO, it is often a sign of significant cardiovascular disease like high blood pressure and they are at higher risk of developing heart attacks or stroke in the future.

Prevention of Retinal Vein Occlusion

Patients with high blood pressure, high levels of cholesterol in their blood, and who have diabetes are at increased risk of developing RVO. It is important to ensure that these common diseases are well controlled in order to reduce their future risk of getting RVO.

Patients with rare diseases like thrombophilia (blood clotting disease) or high levels of homocysteine are also at risk and need good control to prevent it from occurring.

Once a patient has got RVO in one eye, they have a 15% chance over five years of getting it again in the same eye or the other eye. It is important to screen patients for those diseases in order to treat them to prevent future occurrences of RVO.

Patients with RVO have a higher risk of death from heart attacks and stroke and it is even more important to treat these systemic diseases, especially high blood pressure, to prevent that from happening.

Excerpt: AsiaOne

False health
There are quite a lot of people in this group. One feels “healthy” because there are no symptoms. A guy suffering a heart attack while playing a game of tennis may not have known a day earlier that he had heart disease, which in fact had existed years before. The abruptness of the episode is just the end-point of a disease that has been lurking in him.

Similarly, by the time cancer is detected by conventional methods, the sufferer is already harbouring a billion tumour-stricken cells. At the early stage of false health, there are no symptomatic warnings. The irony is that many are aware of the need to undergo routine medical screening and are actually concerned about their health.

Medical tests are meant to diagnose diseases. A normal test result is reassuring but does not guarantee true health, thus many people with the perfect report may erroneously carry a false sense of security. The above mentioned conditions are not specific entities by themselves but related to the root cause of poor lifestyle choices and bad diet.

Sixty-five thousand people died last night. It’s the same number today, and tomorrow. Why are there no headlines?

What kind of horrible plague am I ranting about? They are the silent killers, known as degenerative diseases.

We do not notice them because they are like wear and tear, akin to stealth raiders of our health. After years of straining the engine, the car will eventually break down, as does the body.

Poor health
Like a river flowing downstream, false health will lead to poor health, which is synonymous with “disease”. People in poor health frequently visit their doctors and need long term drugs. Ironically, this is known as secondary prevention, that is, they manage to avoid drastic complications but they live with chronic diseases like high blood pressure and diabetes.

These diseases need medical attention that includes pharmacologic intervention, which forms part of the treatment regime. However, despite the wide array of new and old drugs, heart attack is still the No.1 killer.

Drugs are therefore not the only answer. Taking prescribed medications without a disciplined change in lifestyle and diet falls short of the ideal 6/4/2010 Heal thyself http://thestar.com.my/health/story.asp… 2/4 treatment plan.

The worst situation is to be in the category of end-stage disease. Chronic heart failure, paralysed by a stroke, advanced metastatic cancer, on dialysis, dementia … the grim list goes on.

The bad news is this not only afflicts the elderly, but more and more so, the younger generation. The good news is these diseases that annually kill people around the world in numbers equal to Malaysia’s population can be prevented.

True health
If we are blessed with 100 years of life, we would wish for 100 years of good health, living a meaningful life. Getting a stroke at 50 and spending the next 30 in bed is not an attractive idea. Quality is more important than quantity. I would strive to add life to my years and not just years to life.

Unfortunately, how many of us are truly healthy? True health by definition is not merely the absence of symptoms but the absence of disease. In the realm of modern lifestyles, with fast foods, fake foods, highly processed meals devoid of nutrients, stress, radiation, chemicals and toxins assaulting us, it’s no wonder our health is under attack.

We are in a war zone, and quite unknowingly, caught in a cross-fire. As in baking, there is a specific recipe necessitating certain ingredients and cooking temperature to make the perfect pastry. In health, too, there is a formula to good health and one for bad. It is a choice we have to make.

We understand the concept of insuring our car, our house, our life, and even our maids in the event they run away. We certainly need to insure our health. Unfortunately, this is one insurance no one can buy, simply because there is there is no such product for sale.

One has to earn it through exercise, attitude, recreation and nutrition (EARN). Accumulating one billion ringgit sure means a lot of zeroes. The digit one represents our health. Lose that and all the wealth in the world comes to naught.

Taking charge of our health is holding destiny in our hands as we have a choice to make. To live life by default or by design.

True health is like the balls in the hands of a circus juggler. A mistimed act can result in the balls falling astray. A skillful performer gets it back in the air. If we are unlucky, we may never find the balls again. I hope you won’t lose yours.

Excerpt: TheStar

BREAST cancer is the most common cancer in women. Statistics show that one in 17 women in Singapore will develop this disease. And the bad news is that it has been diagnosed more frequently, especially over the last 15 to 20 years.

The possible reasons for this include more women undergoing medical screening, changes in diet and lifestyle as well as getting pregnant for the first time at a later age.

The first sign of breast cancer is a lump in the mammary tissue. When this shows up, it is crucial to see a doctor who may then refer the patient to a specialist. The specialist performs what is known as “triple assessment”.

The good news is that not all lumps in the breast are cancerous. However, when a lump is discovered, it is important to check it out.

Once we know a lump is not cancerous, we can rest easy and sometimes we don’t even have to remove it. A common non-cancerous lump is a fibroadenoma, which may occur on its own or multiply. These lumps are removed only if they cause discomfort or pain or increase in size.

The triple assessment, found to be the most accurate in diagnosing whether the lump is cancerous or not, starts with a physical examination of the lump. The next step involves radiological imaging (mammogram done on a machine like the one pictured on the left or an ultrasound scan).

It is the third step, where a fine needle is inserted into the lump to extract some cells for examination under a microscope, that can finally determine the presence of cancer. If all three steps show negative results, we can be 98 per cent sure there is no cancer.

If any of the steps don’t provide clear results, then further tests may be necessary. For instance, if the mammogram shows areas of calcium deposits, sometimes magnified X-ray views are required to have a closer look at the calcium. If the needle test is unclear, then some patients are recommended surgical removal of the lump.

An unfortunate consequence of these tests is the anxiety felt by the patient while awaiting the results. This isn’t helped if the result is ambiguous, preventing the doctor from determining if the lump is cancerous or not.

However, there is no more accurate way of assessing breast lumps so the steps should not be changed. In fact, the best way to reduce anxiety is to perform all the tests quickly so that the waiting time between tests and results is greatly reduced.

Source: AsiaOne

Osteoporosis means “porous bone.” If you looked at healthy bone under a microscope, you would see that parts of it look like a honeycomb. If you have osteoporosis, the holes and spaces in the honeycomb are much bigger than they are in healthy bone.

This means your bones have lost density, or mass. It also means that the structure of your bone tissues has become abnormal. As your bones become less dense, they become weaker.

For some people affected by the disease, simple activities such as lifting a child, bending down to pick up a newspaper or even sneezing can cause a bone to break.

Many of the choices you make each day can affect your bones. By making healthier choices you can help to reduce your risk of osteoporosis as well as the painful fractures it can cause.

a) Calcium. Calcium is a mineral that is important for healthy bones. It is a building block of bone.

b) Vitamin D. Vitamin D is important because it helps your body use calcium. If you don’t get enough vitamin D or if your body does not absorb it well, you are at much greater risk for bone loss and osteoporosis.

c) Phosphorous. Like calcium, phosphorous is a part of the bones. Because this mineral is naturally present in many foods, most people get enough phosphorus. It is sometimes added to processed foods and soft drinks in the form of phosphate or phosphoric acid. While some experts say that Americans may be getting too much phosphorous, many experts believe that phosphorous intake is not a problem as long as people get enough calcium.

d) Other Minerals and Vitamins. Magnesium, vitamin K, vitamin B6 and vitamin B12 are some of the many minerals and vitamins that are important for bone health. If you eat a well-balanced diet, you should be getting enough of these nutrients. Most experts recommend multivitamins or supplements for people who do not get what they need from foods.

e) Protein. Eating foods that supply protein is important for your health. But a very high protein diet, particularly animal protein, causes a loss of calcium through the kidneys. You can make up for this calcium loss by getting enough calcium to meet your body’s needs.

f) Caffeine. Found naturally in coffee and tea, caffeine is often added to soft drinks. Caffeine may decrease calcium absorption. One study suggests that drinking 330 mg of caffeine, or about four cups of coffee, daily increases the risk of fractures. To protect your bones, try not to have too many drinks with caffeine each day. You can also offset the calcium lost from drinking caffeine but increasing your calcium intake.

g) Soft Drinks. Some people are concerned that the phosphorous and/or caffeine in certain soft drinks may harm bone health. Other experts suggest the harm to bone is caused by people substituting soft drinks for milk and calcium fortified juices. In other words, when soft drinks take the place of milk and other sources of calcium, bone health may be affected.

h) Sodium (salt). Eating foods that have a lot of sodium may decrease your body’s ability to retain calcium. Eating too much sodium is bad for your bones and can cause bone loss. Try cooking without adding extra salt, and limit the salty snacks and processed foods that you eat.

i) Spinach. Spinach contains high levels of oxalate. Oxalate prevents the body from absorbing calcium from spinach. The body can absorb calcium found in most other green vegetables such as broccoli and kale. Although spinach can be part of a healthy diet, it just can’t be counted as a source of calcium. It does not affect calcium absorption from other foods.

j) Wheat Bran. 100% wheat bran is the only food that appears to reduce the absorption of calcium in other foods that are eaten at the same time. If you are taking calcium supplements, you may want to take your supplement two or more hours before or after eating any foods with 100% wheat bran. Although wheat bran may interfere with calcium absorption, foods with wheat bran are still considered a part of a healthy diet.

Courtesy: National Osteoporosis Foundation

Given a choice, would you rather detect your cancer at stage 0 and 1 OR stage 2 and above? Who can you blame when your doctor tells you ‘I’m sorry, but this is stage 4″?

It is say that your life is fated. Yes it is, we can’t stop earthquake or other catastrophe from happening. But if you can detect the disease early and you disregard screening as important in the first place, is this called fate?

No, it’s a result from your own ignorance, who can we blame when we put ourselves to suffer which results in suffering to family members, kids and relatives too?

Make it a point today to schedule for your yearly comprehensive health screening. You can’t be too busy for that. What is more important that your own health? If you never set priority for your health, it could be too late when you discover it.

Cancer is curable, but again it depends on the stage of the disease. The earlier you detect it, the higher your chances are and the lower the costs involved.

The irony is that most people do not seem to give this much thought when they feel no pain. Even if there’s a certain discomfort, we usually like to shrug it off as ‘normal’ symptoms. But the truth is once you feel something is wrong, 80% of the time it’s already too late.

“Colon cancer, nasopharyngeal (nose and throat) cancer are very curable types of cancer when you detect it early, and even lung cancer can be cured if you catch it in the early stages,” says Dr Low.

But if you are looking for proof of progress in the survival time of cancer patients, you do not have to look further than lung cancer.

“Lung cancer used to be fatal, once you get it, within a year you’ll die,” says Dr Low. “If you receive chemotherapy you’ll probably live for eight months to a year, but if you don’t, you could probably only live for six months,” he says.

Excerpt from TheStar.