A general physician's part-time musing about parenting, lifestyle, health and beauty issues
Monday, June 22, 2020
Is Microneedling worth trying? | Common Labs Vitamin E Microneedle Spot Cream Review
Tuesday, June 16, 2020
Is Vitamin C Supplementation necessary? | EC Pomegranate Mixture Review
When I was younger, my mom asked me to pop a vitamin C tablet every morning. I simply enjoyed the taste of the sweet chewable tablet. But is it necessary? Vitamin C is one the safest supplements one can ever take. It may not be the panacea to everything. But it really does have benefits in boosting the immune system, protecting our heart, brain and eyes. Not to mention the anti-ageing effects. Therefore, it is not surprising to know that Vitamin C Supplementation is beneficial against Covid19 infection. You can find the published study here.
However, most of the benefits are only seen at a higher dose of at least 500mg daily. It is simply not practical to consume that from our normal dietary intake. On top of supplementation, we will still have to take 5-9 servings of fresh fruits and vegetables everyday. The safe dosage of vitamin C Supplementation varies to age and gender and can be found in this article.
There are so many Vitamin C preparations out there- chewable tablets, effervescent tablets and liquid formulation. We do know that some preparations stronger than 500mg can cause some stomach lining irritation and discomfort, so look for a non-acidic, buffered form of the vitamin. This is why I consume EC Pomegranate Mixture regularly.
Read more about Vitamin C Supplementation on WebMD.
Pureway C is the more superior form of vitamin C in the form of its fatty metabolites. This allows faster absorption from the gut into the bloodstream and to the cells where it's needed. Pureway C also has potent antioxidant effect that remove free radicals that can damage normal cells and cause premature ageing. It is approved by the European Food Safety Authority (EFSA), categorized as Generally Recognized as Safe (GRAS) by the FDA. This preparation is also stomach friendly.
Besides that, EC Pomegranate Mixture does not contain added sugar. It's naturally sweetened by apple and pomegranate juice. Apple and Pomegranate contain strong antioxidants, vitamins and minerals. This help to supplement our daily fruit intake, all compressed into 15ml and 400mg of vitamin C goodness.
What does Dr Yingzangel think?
You may think I'm a non conventional doctor. I am not against all sorts of supplementation but I do urge people to be alert and vigilant. Study about the product before consuming from valid sources. Only buy from reputed sources and not some herbal shop with homemade supplements made in the back alley. People love supplements undoubtedly. However, those with chronic illnesses- kidney failure, liver failure,heart failure and diabetes need to steer away from supplements and herbal remedies. If you really want to try, bring it to your doctor so you are monitored regularly if needed for side effects.
Disclaimer: the opinion given is merely a personal experience and does not constitute formal medical advice. Please seek your medical professional's advice before any complementary therapy. Always ask for certified professionals before proceeding with treatment and stop if discomfort or side effect ensues.
Jasper Live Series: How to protect our seniors from covid 19
Please introduce yourself
Hi everyone. I am Dr Angel Ho. I am a specialist in internal medicine and will pursue further studies in geriatrics which is the care of the elderly. I am also one of the visiting specialist at Jasper Lodge-- which is a franchise of doctor-managed nursing homes, aiming to provide quality care to the residents.
Besides being a fulltime doctor, I am also a partime blogger at www.dryingzangel.com . I enjoy sharing about healthy lifestyle tips with my readers. If you google @yingzangel, you will be able to have a look at my IG, FB page, blog as well as YouTube.
A little bit more information about myself. I am a mother to 2 active boys and wife to Dr Ryan, a wound care specialist. Both our parents are already more than 60 years old. So we are very much aware of how important it is to keep them safe and healthy nowadays.
Besides that, I love talking and listening to people’s experience. And I absolutely love whipping up healthy nutritious meals for my family (which sometimes is disapproved because in my kitchen, every dish is low sugar, low salt and less oil)
I have shared today’s live series on my FB and IG as well. I hope you feel as excited as I feel right now! Do share the live video with your family and friends because we are going to discuss about a very important topic today-- which is how to protect our parents from covid 19.
Why did you choose to pursue the pathway of becoming a Geriatrician? And what exactly does a Geriatrician do?
When I was much younger, I thought I wanted to do something sexy, something more exciting like being a cardiothoracic surgeon. Perhaps I was fairly impressionable and was really inspired by Team Medical Dragon which was a popular Japanese drama series back then.
As I gained more experience, I noticed that healthcare for older people in Malaysia really needs attention. I grew passion in caring for them. Even though it can be really difficult to get a concise and precise assessment when you are time pressed because most older people just have too much to tell! But sometimes all they need is just some therapeutic talking.
A geriatrician is trained to treat people older than 60 years old. Because as we age, the bodily functions change due to wear and tear. And we cannot treat older people the same way we do with other grown ups. A geriatrician is also sensitive to the multiple interactions between chronic illnesses, medications (you will be surprised at how many drugs a person takes both from various doctors and over the counter!) and other social as well as psychological factors that contribute towards the health of an elderly person. It can be extremely complicated and most of the time, requires a multidisciplinary team of healthcare professionals to tease out the issues. The study of geriatrics is about empowering our elderly population -- to improve quality of life and optimize social participation.
Give us an update on the COVID-19 situation in Malaysia, where do you think we are heading towards?
Malaysia is indeed quite lucky in the sense that local transmission of the disease has been managed to be controlled due to an effective MCO. We have diagnosed almost 8500 cases of covid 19 throughout the country with a recovery rate of 82% and death rate at only about 1%. Not surprisingly those who did not make it were mostly elderly with multiple medical illnesses. And this is precisely why we are having the discussion today-- about how to protect our loved ones who are the most vulnerable.The trend is definitely down going. We need to continue with our efforts to stop it from climbing back up again.
The most important point here is only obtain your information from official portals. To get the latest accurate covid 19 statistics, please join the following telegram accounts : Majlis Keselamatan Negara and CPRC KEMENTERIAN Kesihatan Malaysia. ALternatively, download MySejahtera App to know hotspots around certain areas.
I understand that you are mainly working with elderly seniors. How do you think COVID-19 has impacted the lives of the senior population in Malaysia?
The aged, unfortunately, have suffered the most in this pandemic. Taking Italy as an example, most of the Covid 19 deaths occurred among the elderly with multiple medical problems such as diabetes, heart problems and not surprisingly with dementia. They are often the ones with weaker immunity and are much easier to get infected. Besides that complications from the infection such as kidney failure and the need to be on life support machine can often spell disaster in this age group of patients.
For those who are relatively healthy, social distancing measures make people feel isolated. Many elderly people are restricted from their morning walks and grocery shopping. It can be extremely depressing when they are confined to their home for long periods of time. Sometimes, caregivers become stressed out as well, especially for those who care for older people with dementia. For example, Mr A has problems with wandering to nearby coffee shop which is not allowed during MCO. He gets argumentative when being stopped from going out. Usually his main caregiver who is his daughter gets some respite from visiting siblings from interstate once a week. But due to MCO, they are unable to travel interstate to care for their father. So you can imagine the stressful situation in the household.
Many elderly have an assortment of medical conditions. What should we be more worried about? Managing their existing medical conditions or avoiding COVID-19? If so, what course of action should we be taking?
Both are equally important. That is why we have implemented a few contingency plans for this.
For elderly with other medical problems-- we usually delay their clinic appointments until later dates if their condition is stable. That is via reviewing their blood test results which may eliminate the need for the patient to have a face to face clinical consultation. This is because we have to implement social distancing measures in all outpatient clinics. And to make sure the patients we really need to review are seen fast with a short waiting time.
We are in the process of setting up virtual clinics. We will set up computer systems to have virtual consultations with patients whom we have determined to be able to self monitor to a certain degree. We do have to be very careful to select our patients because we are not able to perform clinical examination during virtual consultation. When in doubt, we may still need to call the patient back to see them in person.
As for regular medication top ups, our pharmacy department is very helpful in terms of setting up drive through, locker as well as mailing systems to the nearest clinic or even to home. This has greatly reduced the queue and waiting period at the pharmacy.
The government is doing free PCR swab tests for all nursing homes, care centers and old folks home staff and residents in Malaysia. What about those staying in such facilities? How do you think we could protect them?
I really applaud the move to do PCR swab for people who stay in nursing care facilities. If you look at the situation in the US, they only detected covid 19 in their nursing facilities after a sudden surge of initially unexplained deaths. This is a painful lesson that we should learn because many older people simply present in an atypical manner-- many just become confused and refuse to eat. Rarely they will come to doctors with the typical fever, cough and shortness of breath. In other words, we tend to underdiagnose possible infections in the older population. By diagnosing more cases via free PCR , people become more vigilant towards suspecting possible infections. This will stop the infection from spreading like wild fire.
In Malaysia, many nursing homes are overpopulated due to high demand. Not to mention that dementia is highly prevalent, under diagnosed and under managed. As I mentioned before this, people with dementia are at the highest risk of dying from covid 19 infection. Social distancing is also definitely a huge issue in these settings. We, in fact, will not be surprised if good respiratory etiquette and social distancing is not being practiced in many centers. People are just not aware of it. And it can be a real struggle to ask people with dementia to wear masks and wash their hands.
I strongly advise nursing homes to adhere strictly to the Malaysian Society of Geriatric Medicine guidelines. Please take hand hygiene and good respiratory etiquette very seriously. Visitation should be limited to only next of kin with screening of temperature upon entry. But this does not mean that residents are locked up. Because the centers should have daily social activities modified to less physical contact such as colouring and mental arithmetics so as to adhere to social distancing measures. Other means such as video calls between residents and their loved ones should also be arranged . Physically isolating the residents is the key to protect them.
Moving forward, how can we as a community protect our seniors? How should seniors protect themselves?
Our community needs to be aware that covid 19 is here to stay. Therefore, we have to adapt to the new normal. As there is a possibility of asymptomatic carriers, everyone has the responsibility to break the chain of transmission by- wearing masks, washing hands or using hand rubs, staying at home as much as possible especially when you have cold like symptoms. Remember young healthy people may have little or no symptoms but if the infection is passed onto the older age groups, it may mean life or death for them.
Similarly, our seniors need to be equally vigilant. Be aware and avoid sick contact. Even though they may miss their loved ones very much, they will need to practice social distancing as much as possible. We really have to learn from our Muslim friends, for example, for doing so well this Raya Season-- No open house and just BerRaya Di Rumah.
What other advice would you be giving us to move forward after the COVID-19 pandemic? How should we and our senior population prepare ourselves in case of another outbreak or pandemic?
The virus is here to stay and we human, as a community, just have to live with it and make adaptations to our old practice. Reduce physical contact, but we can still communicate to each other frequently and effectively by using technology. There are so many free applications like WhatsApp, WeChat, Skype and Zoom that allow interactive virtual communications. As for shopping, there are so many platforms like Shopee and Lazada which make online purchase fast, secure and convenient.
Humans are blessed with brains so we can think and plan around unfortunate circumstances like this. This is for survival sake. And it is no joke. In the healthcare setting, we are also actively trying to adapt to the new normal while still providing the best quality of care to our patients. Now that daycare centers are opened and schools are to follow suit gradually, we really have to protect our children as well. It is really just the same sets of advice here- wash your hands, cover your mouth and your nose while sneezing and coughing, wear masks and stay at home as much as possible.
These advice applies to many other infectious diseases and we as a community have to embrace the change for the better.
Monday, June 15, 2020
Probiotics and Prebiotics for Children | H2Kid Review
Since the day we are born, our gut is full of bacteria (called microbiota). Don't be disgusted because they are good bacteria. They are hardworking creatures helping to break down and digest food, feedback to the immune system about gut's health status and dampen inflammation. Our two main BFFs are Lactobacillus and Bifidobacterium.
So how do probiotics and prebiotics fit into the picture? Probiotics are living bacteria isolated from human, grown (cultured) in the laboratory and then made into supplement. When probiotics are consumed, the good bacteria goes and populate in the gut. Prebiotics is simply food for probiotics. It doesn't get digested by our body so it goes straight to the bowel, to our BFFs in the gut who can feast on it.
Does everyone need to take probiotics and/or prebiotics then? Not really. If you are able to eat clean and healthily all the time. And have no issues with indigestion, then there's no need. But if you are like me- work hectically, no fixed meal time, eat outside food a lot, have a bloated and gassy stomach most of the time, as well as constipation. Then you should give it a try. Or if you have chronic illnesses especially those involving your gut such as irritable bowel syndrome, you will definitely benefit from it.
Read more about probiotics and prebiotics from this article at ClevelandClinic.
What is H2Kid?
H2Kid is a gluten free natural supplement for children. It contains probiotics and prebiotics in the form of Bifidobacterium and galacto-oligosaccharides (GOS). It is flavoured by 100% natural real berries-- Cranberries, blackberries, raspberries, as well as acerola berries. Therefore it's naturally sweetened without added sugar. These berries are rich in vitamins, minerals and antioxidants. Besides being tasty, they are absolutely safe for children.
Read here to know more about the safety of probiotic use in children.
How to prepare H2Kid?
H2Kid can be mixed in cold/room temperature/warm water or juice. It doesn't need to be refrigerated either unlike some other probiotics. Children older than 1 year old can consume H2Kid.
Other additives in H2Kid are:
Water soluble fiber to soften stools, regulate bowel habits and ease constipation.
Papain enzyme to improve digestion, leading to better appetite.
DHA & ALA are important for brain development and general well-being.
What does Dr Yingzangel think?
It can be a real struggle to get my boys to take in enough fibre. They don't really have problems with taking in water thankfully. On the odd occasion, they do suffer from constipation. It's heart breaking to see them cry because of the colicky tummy ache. Giving commercially prepared laxatives is not easy due to the taste. Luckily H2Kids is very well accepted by my boys as the berry taste is delicious.
Want to try H2Kid and witness the change for your children? We are giving away 10 units of H2Kid for free! Just follow the steps:
1. Follow H2Kid FB page https://www.facebook.com/h2kidmalaysia/
2. Tag 3 friends in the comment section of this post.
3. Share, like and follow my FB OR Repost, like and follow my IG!
Deadline on 15 July 20!
Whole food vs multivitamin for the picky eaters | Oscokid Review
Hands up if you have picky eaters at home! Meal times, if we are lucky, the boys will eat what's served. Sometimes, their favorite food may suddenly become a 'poison' in their eyes! Introduction of each new food can be a really daunting experience. With us parents end up to lose our mind at the dining table. How to get enough nutrients for the growing kids then? Multivitamins will only provide certain minerals and vitamins. It's still better to give whole food. Read this article from WebMD when should your kids get vitamin supplements.
Luckily they love Oscokid! Oscokid is 100% plant based milk using Organic millets and Organic Soy milk as the base. So it's suitable for children with special dietary needs such as those with celiac disease, cow's milk allergy and lactose intolerance. These children cannot take normal cow's milk based milk as their body cannot accept it causing diarrhoea and malabsorption. It is also great for those who are vegetarian by choice.
Read more about celiac disease, cow's milk allergy and lactose intolerance.
Oscokid is a high protein beverage that is specially formulated for growing kids and youth with no preservative and additive. The proteins are non GMO sourced from organic soybean and organic millet which are the building blocks in human body. Isoflavones which are abundant in soybean, promote healthier and stronger bone growth.
Millet, on the other hand, is rich in iron which is important in red blood cells formation. Do you know that iron deficiency anaemia in children is a correctable cause of delayed cognitive development! Coarse rice provides various types of vitamins, (especially A&B), minerals and water soluble fibers for health and better bowel regularity.
Besides that, Oscokid has the following natural additives:
Phosphatidyserine (PS) is an important nutrient to improve general mental performance, including the ability to focus, better impulse control, short-term auditory memory and learning without becoming easily fatigued. In other words, this may help children with Attention Deficit Hyperactive Disorder (ADHD).
Lutein is a strong antioxidant that is naturally present in the eyes to protect the eyes against UV light related damage such as premature cataracts and macular degeneration later on in life.
DHA and ALA, sourced from seaweed and perilla seeds, helps in brain development.
Prebiotics, in the form of fructo-oligosaccharides (FOS), softens stools to ease bowel movement and relieves constipation. It also promotes calcium and magnesium absorption from our daily diet.
Even though Oscokid has the umami taste, it doesn't contain sugar/gluten/sucrose/lactose.
What does Dr Yingzangel think?
Oscokid Travel Pack really tides us through difficult meal time scenario. Instead of giving in to sweet snacks, we bring out sachet of Oscokid to save the day. The important thing is both boys really love the taste. Even I love it! We just need a glass of water and a spoon to prepare an instant and nutritious meal for the boys! The sachets are small and easy to bring along while travelling. So if you have picky children like mine, try Oscokid Travel Pack. It also comes in 800g tins.
My lucky readers, please thank Oscokid Malaysia for sponsoring 3 units of Oscokid Travel Pack. Just follow these simple steps to win yourself a pack of goodness!
1. Follow Oscokid FB https://m.facebook.com/pg/oscokidmalaysia/
2. Tag 3 friends in the comment section of this post.
3. Share, like and follow my FB OR Repost, like and follow my IG!
Deadline on 30 June 20!
Sunday, June 14, 2020
No-wrap Healthy Glutinous Rice Dumpling
Wednesday, June 10, 2020
Masked face and Double Cleansing | Chrisear White Milk Cleanser Review
Welcome to the new normal!
Masked faces and even face shields are the way to go, probably for the next 6 months. What does this mean to me as a full-time doctor? On average, I have to wear a 3 ply surgical mask for up to 9 hours a day, perhaps even longer when I'm on call.
Do you know that prolonged face mask use can cause skin damage? The tight fitting N95 masks tend to feel fairly suffocating to breathe in, and the edges of the mask can exert significant pressure on skin surface, causing pressure injury especially where the skin is thin and near to bony surface. Even normal surgical masks can increased humidity level and skin irritation due to trapped sweats under stressed conditions, causing acne, itchiness and rash.
Wound care experts from the European Wound Management Association and NPIAP (US) have spoken extensively with this regards. You can find the video here. And the article here.
What can we do to mitigate the risk?
A good skincare regime is the key. Cleansing and moisturizing are important steps to prevent skin problems. In certain cases, preventive dressings can be applied on the face to stop pressure injury from developing.
Will double cleansing help?
Double cleansing is the backbone of many popular Korean skincare regimes. At the end of the day, it is extremely vital to clear our skin off dirt, impurities, pollutants and makeup residues. Even if one doesn't wear makeup, it is still important to double cleanse as impurities can cause premature skin ageing including sun spots and wrinkles.
The first step of double cleansing involves an oil based cleanser (examples include Chrisear White Milk Cleanser) or micellar water. This removes makeup and sebum buildup without stripping the skin off natural oil.
Step 2: Use a lathering cleanser to wash upwards and outwards in the direction of the hair follicles for deep cleansing.
Step 3: Rinse with water and pat the skin dry.
Chrisear White Milk Cleanser
Chrisear White Milk Cleanser is a non-foaming cleanser with cleansing and makeup removing function suitable for all skin types. It's gentle yet effective so it can also be used around the eyes.
The main ingredients are-
Liquorice provides deep cleansing to unclog the pores so as to prevent acne from forming. It also faints skin pigmentation to achieve fairer complexion.
Isaflavonoids are potent antioxidants which rejuvenate the skin and soothe irritated skin.
It doesn't contain harsh chemicals or preservatives. Therefore, Chrisear White Milk Cleanser is suitable for expecting mothers as well.
What does Dr Yingzangel think?
Whenever possible, I double cleanse before hitting the sacks- at least 2-3 times/week. Honestly, sometimes I'm just too tired. But I'll at least use a lathering cleanser and apply moisturizer. I don't put on much makeup but eye makeups can be notoriously difficult to remove because most are waterproof. Chrisear White Milk Cleanser makes the job much easier. It's lightweight and doesn't burden the skin. At the same time, it preserves natural sebum to protect the skin. I find the light scent relaxing at the same time.
Get your own Chrisear White Milk cleanser at JomBeautii
360° Medi Skin is a certified aesthetic clinic that offers a range of beauty solutions - from medical grade facial treatments to minimally invasive office aesthetic procedures like filler injection and laser treatments.
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