Phimosis Scare

Just a few days ago, my 6 yo son was complaining that it hurts when he was urinating. We got a little worried as he had a history of recurring Urinary Tract Infection when he was younger. It was a very bad experience for us as we had to put him through an x-ray test for urinary reflux/vesico-ureteral reflux (VUR). The test is called Micturating Cysto-urethrogram (MCU). It pains us that he has to go through an x-ray test at such a young age, but I guess it's much better than to have VUR and thus taking risk of renal scarring (kidney damage). Anyway, I'll talk about that some other time.

As I was saying, we got worried about him complaining that it was painful while he was urinating, so we decided to check his penis ourselves and found out that there is sort of a cut there. To be sure, we decided to bring him to see our Sunday pediatrician (since our usual pediatrician doesn't work on Sundays), at the very least, get an antiseptic cream to prevent any form of infection. The doctor said that it's just a small cut or a bug bite and gave us an antiseptic cream.

Since our son is seeing a skin specialist (dermatologist), we also let him take a look at my son's penis for a second opinion. He said that there's no infection but he saw that my wife was having some difficulty retracting my son's foreskin and my son was complaining that it hurts when she tried to retract the foreskin. He then said that there may be tightening of foreskin, which may lead to more problems (such as UTI) when he gets older. He recommended us to see a pediatric surgeon in SDMCSJ (previosly SJMC - Subang Jaya Medical Centre) to do a circumcision. According to him a pediatric surgeon is gentler and more experience operating on children as compared to a pediatrician or a general surgeon. The operation should only take about 10 mins but he would have to stay for half a day in the hospital. We asked if it's something we needed to do it immediately and he said we can do it within the next six months.

It was then I decided to do a search online and found out about Phimosis.

According to Krames Online:-

In uncircumcised boys, the foreskin lies over the head of the penis. It begins to loosen from the head of the penis by age 3. This allows the foreskin to gently retract (slide back) over the head of the penis. In some boys, the tip of the foreskin (prepuce) is very tight, making it difficult to retract. This is phimosis.

The unretracted foreskin and prepuce cover the penis. Retraction of the foreskin uncovers the head of the penis. (Source: Krames Online)

Phimosis is most likely to be identified between 4 yo to 7 yo since for younger children, their foreskin may not be able to fully retract. The last time our son got his penis checked was when he was younger (around 2 or 3 yo), so we decided to let our usual doctor check him again. Thankfully he said that he doesn't have the signs of Phimosis. It probably hurts because he was terrified by last few days experience and furthermore it's a sensitive area. He just need some getting used to the stretching of foreskin and slowly it will be able to retract. There's no rush, according to him. He also does not recommend going for circumcision until he's a little older because if we do it now, he will need to go under General Anesthetic as he's probably too immature to stand still for the administration of a Local Anesthetic.

In any case, we're glad that our son is ok and nothing needs to be done at the moment, thank God!!

To get more information about Phimosis, when to see the doctor, and the treatment for it, please visit Krames Online.

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Pica?!!

My wife was a quite worried about eating seafood as she is in the first trimester and some seafood is known to contain high levels of mercury, and so I did a google search on it. As I was reading an article about eating during pregnancy from KidsHealth, at the food cravings section, I came across this word - Pica.

What in the world is Pica?? The only Pica I know is the noise that Pikachu made in Pokemon LOL! So I clicked on the link and this is what I learnt:-

Pica is an eating/medical disorder (it's also a unit of measurement, but that's not what I'm talking about) characterized by having an appetite mostly for nonfood or non-nutritive items which can also include food ingredients.

While it's normal for young kids to put various items into their mouth (most kids do that at some point in time) since it's how they explore and learn about their surroundings, kids with Pica goes beyond innocent exploration and it's characterized by persistant and complusive cravings.

Pica can be seen in young children (especially those who are developmentally disabled), pregnant women (as food cravings), people with epilepsy and also in animal (mostly dogs). It can last for one month or longer.

Here are some examples of nonfood items people with Pica normally crave or consume (source: KidsHealth):-
- dirt
- clay
- paint chips
- plaster
- chalk
- cornstarch
- laundry starch
- baking soda
- coffee grounds
- cigarette ashes
- burnt match heads
- cigarette butts
- feces
- ice
- glue
- hair
- buttons
- paper
- sand
- toothpaste
- soap

Below is a picture of items found in a pica patient's stomach (picture obtained from Wikipedia)

1,440 items found in a patient suffering from Pica

Ewww!! We learn new things everyday, and I learned that we're living in a crazy world that's always full of surprises LOL!!

To read more about Pica such as signs and causes of it; treatment etc, please visit the sites below for more information.

References:
1. Wikipedia
2. KidsHealth

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War On Dengue (& Chikungunya)

As far as parenting is concern, some news just doesn't sit right with me. For example:

Taken from http://thestar.com.my/news/story.asp?file=/2009/1/20/nation/3065279&sec=nation
Tuesday January 20, 2009

War on dengue
By LOH FOON FONG and AUDREY EDWARDS

PETALING JAYA: The Health Ministry has declared war on dengue following an alarming rise in cases and related deaths in the first two weeks of the year.

Minister Datuk Liow Tiong Lai also raised an alarm against chikungunya, which has seen a sharp rise in the number of cases from last year.

Liow, who described the spike in cases as “unusual”, warned that the situation could worsen if there was not enough co-operation from all parties involved.

Go here for the full story.

After almost 6 years of being parents, one thing still freaks my wife and I out, sometimes a little, and sometimes a lot, is when our kids fall sick. If you're living in Malaysia, especially in Kuala Lumpur (Wilayah Persekutuan) and Selangor area, dengue fever is something that we're always watching out for.

But wait, I know about dengue fever, but what in the world is this Chikungunya virus they are talking about? Well if you have not read about it, the Aedes mosquito is the carrier of both Dengue and Chikungunya virus.

First, let's take a look at the little buggers,

From Wikipedia:
The yellow fever mosquito, Aedes aegypti (=Stegomyia aegypti, =Aedes (Stegomyia) aegypti), is a mosquito that can spread the dengue fever, Chikungunya and yellow fever viruses, and other diseases as well. The mosquito can be recognized by white markings on legs and a marking of the form of a lyre on the thorax. The mosquito originated from Africa^[1] but is now found in the tropics worldwide^[2].

Aedes Mosquito - See it, Fear it, KILL IT!

Aedes mosquitoes are most active early morning and late evening. Avoid bringing your child/children out at those times and avoid bringing them to crowded places as the mosquitoes spread the diseases through bites. I know it's kinda hard sometimes, but at least try avoiding public places such as shopping complexes that you know have a lot of mosquitoes, especially at places with high dengue cases.

Quick facts on Dengue and Chikungunya:

To make it easier for you to read, I've compiled information about Dengue Fever and Chikungunya I collected from various sources and tabulated it. Hope this is helpful. I will provide the links to the sources at the end of this post so that you can go and read more about it.

	Dengue Fever	Chikungunya
Incubation Period	Approximately 4 days	Ranging from 3 - 12 days, usually 3 - 7 days
Signs & Symptoms	Sudden burst of continuous high fever (3 - 7 days) Red rashes on skin (may appear as fever reduces) Acute pain in bones, muscles, joints, eye-balls and head Loss of appetite Vomiting Stomach Pain Bleeding from body, nose and mouth	Sudden onset of high fever Redness with rashes appearing on the hand, leg and body Headache Severe joint pains Nausea and vomiting Redness of the eyes Fever can occur for a period from 1 - 7 days (usually 5 days) (Commonly mistaken for dengue fever)
Rush to hospital when	High fever with bleeding symptoms Suspect Dengue Haemorrhagic Fever (DHF)(Severe Dengue with complications) Blood spots under the skin (petechiae) Bleeding from gums Nose Bleeding (epistaxis) Vomiting blood (hematemesis) when acompanying normal dengue symptoms	In Malaysia, Chikungunya has never been reported as causing haemorrhage ordeath
Care & Treatment	No specific treatment, must let it run it's course Use supportive care - pain relief, drink fluids, rest - Use Panadol (paracetamol) - Do NOT use aspirin (salicyclic acid) - Do NOT use ibuprofen Watch out for bleeding symptoms (DHF)	No specific treatment treated symptomatically (treating for specific symptoms) Majority need only outpatient treatment
Vaccine	No vaccine	No vaccine
Immunity	There are four types of dengue viruses DEN1, DEN2, DEN3 & DEN4. A person infected with one type of dengue will subsequently only be immune to that type. They will not be immune to other types of dengue and will, in fact, be at risk of developing severe symptoms if they contract another type of dengue.	Most patients who have been infected will be immune for life.
Is it Contagious?	It is not contagious, in other words one human can't directly pass to another human. However an aedes mosquito after biting an infected person can transmit the disease by biting someone else	Same as dengue

One of the best way to battle these diseases is to prevent the Aedes mosquitoes from breeding. Click the below flyers/posters provided by http://www.infosihat.gov.my to learn how to do it.

Chikungunya

Dengue Fever

Dengue Fever

References:
Do visit these sites for more information on Dengue Fever and Chikungunya:
1. Wikipedia (on Aedes Aegypti)
2. Info Sihat (for both diseases)
3. World Health Organisation (WHO) (for Dengue Fever)
4. Queensland Government website (for Dengue Fever)
5. www.stanford.edu/group/virus/flavi/2000/dengue.htm (for Dengue Fever)
6. diabetescare.yoscare.in/content/chikungunya-what-you-must-know (for Chikungunya)

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Jason Mraz coming to KL!!!! - [Random Ramblings]

Oh my goodness!!

One of my favourite artist is coming to KL on the 4th of March, 2009!!

Taken from Axcess website:

Jason Mraz Tours KL!

Following the release of his highly anticipated new album “We Sing. We Dance. We Steal Things.”, Marctensia, the concert organizer is pleased to announce that the multi-talented Grammy nominated singer-songwriter Jason Mraz will be touring Kuala Lumpur. Jason Mraz’s concert will kick off on the 4th of March 2009, Stadium Negara at 8:00p.m.

Ticket prices are categorized into RM68 & RM88 (free seating), RM168 & RM208 (number seated) and RM138 (Rock Zone standing and RM258 (The Pitt standing – limited tickets only) and there will be an exclusive early-bird sale event coming this Saturday, 17 January at Sungei Wang Plaza Concourse from 12pm – 3pm; offering one-off early-bird 15% discount tickets to Jason Mraz Live in Malaysia 2009.

To read the full article, concert, and ticketing details, go and visit Axcess.

Having bought all 3 of his studio releases, namely "Waiting for my rocket to come" (2002), "Mr. A-Z" (2005) and the newest album "We sing, we dance, we steal things", I have to say my favorite is still the first album, "Waiting for my rocket to come". I like ALL the songs in there. Apart from the obvious favorites like "The Remedy (I Won't Worry)" and "You and I Both", I really like "Curbside Prophet". All the other songs are very easy to the ear as they are lively and catchy. I do hope he'll play quite a few from this album.

There are only 3 songs which I really like from the album "Mr. A-Z", they are "Wordplay", "Geek In The Pink" and "Life Is Wonderful", and 4 songs from the latest album, namely "I'm Yours", "Lucky", "Love For A Child" and "A Beautiful Mess". The rest of the songs are not too bad as well. Btw, the reason I'm linking those songs to their lyrics is because I love to sing, and online lyrics (especially Jason Mraz's songs since you can't get the lyrics from the album) are God sent LOL!! Also check out the videos of the above songs (mostly Live performance) at the end of this post. You MUST MUST MUST listen to Curbside Prophet Acapella!!

See! Now you can listen, watch and sing Jason Mraz's best songs here at this blog. A great service I'm providing you with wouldn't you say LOL!

All I'm saying is, I CAN'T WAIT TO GO TO THE CONCERT!! The only question I have right now is, with the limited budget that I have, which seating category should I go for, hmm......

The Remedy (I Won't Worry)


You and I Both


Curbside Prophet Acapella! Check it out!!


Wordplay


Geek In The Pink


Life Is Wonderful


I'm Yours


Lucky (with Colbie Caillat)


A Beautiful Mess


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Coping with Depression

First of all, thanks Ginger of Chasing Rainbows for compiling and written a concise and useful article on depression, mainly in women, and also postpartum depression.

After reading, I decided to write about this topic as it is something that is close to my heart as my wife was suffering from depression in the past for many years. Because of her great desires to change and to improve the quality of her life, with great determination, discipline and God given ideas (there were times God would give her ideas of how to deal with and come out of a depression episode), today, she has overcome it. She had also experienced postpartum depression especially with our firstborn. I will split into two posts as it will be too long for a single post.

Rather than giving you the scientific facts and info, which you can find from many other sites (you can find the links at the end of this post), I will instead share from our own personal experience as well as the experience some of the people we know who’s going through depression.

What is Depression:

I like the definition given in Chasing Rainbows, so do check it out.
According to Wikipedia: Major depressive disorder (also known as clinical depression, major depression, unipolar depression, or unipolar disorder) is a mental disorder characterized by a pervasive low mood, low self-esteem, and loss of interest or pleasure in normally enjoyable activities. Major depression is a disabling condition which adversely affects a person's family, work or school life, sleeping and eating habits, and general health. In the United States, approximately 3.4% of people with major depression commit suicide, and up to 60% of all people who commit suicide have depression or another mood disorder.

As serious as it may sound, unfortunately, there are still many people who take depression too lightly. Some are even unaware that they are going through depression since some of the signs can be subtle. People with depression can get better with treatment, but many people (especially in Asian countries) are unwilling to pay a visit to a mental health care professional (Psychiatrist) because it’s embarrassing. Some of us have the idea that paying a visit to the shrink means that you have gone crazy, which is not the case. Many people still fail to understand that having a mental illness does not mean that you’re a nut case. We’re living in a fast paced world where our lives are becoming increasingly stressful everyday and this can cause all sorts of mental illnesses that do not require you to be taken away in a straitjacket. A lot of these illnesses are mild and with treatment, will get better.

As for my wife, with God’s help, and with strong determination to change, she has learnt to cope with depression without the help of medication. To her, depression is like an attack. Having depression according to her, is like having a cloud of extreme negativity covering and saturating her mind. She constantly felt hopeless, helpless, worthless and that life is not worth living and nothing good will ever happen to her. She was unable to feel joy or experience pleasure. She also often suffered from insomnia, and very often she didn’t feel like waking up in the morning fearing that she couldn’t manage another day of her life. When she was pregnant with our first child, she was depressed through out the whole pregnancy. She just could not bring herself to even smile. In the past, when there was a “depression attack”, there’s nothing she could do to prevent or make it go away. All she could do was hoping that it will pass on its own, which may be days, weeks, or even months.


Right now, she has overcome depression. Even though sometimes it will still come back and make life difficult, but nothing unmanageable. According to her, with knowledge and experience, one will be able to know when an attack is going happen. This will help her to prevent herself from falling into the “pits of depression” or to come out of it if she had an attack. We also know of friends who are going through depression, some are coping with it the wrong way, such as overeating, some are still too stubborn to change or seek help.

Over the years, while learning from our own as well as other’s experiences, we discovered what can help a person gets better are:

1. A strong desire to change – stop the blame game
We have met many people that who kept on insisting that it’s not their fault that they are having depression, it’s all because of him/her/that situation that made them like this. What they are basically saying is that there is nothing wrong with them, so they don’t need to change even though they don’t like it. Some are unwilling to change because they think that it’s impossible to overcome despite of all the encouragement they are receiving from the people around them. From our experience, these mindsets and attitude are counter-productive to dealing with depression.

2. Forgiveness
Cases of depression are usually associated with bad past experiences. Sometimes letting go of the bad experiences will mean needing to forgive certain people that have hurt you or done some really bad things to you before. But if you can’t let go/forgive, it will be a stumbling block to dealing with depression.

3. A lot of support and encouragement
One of the reasons why my wife has depression was because she has a very strict, perfectionist and hard to please mother. Through out her childhood, she was always being disciplined because the things she did were just not good enough for her mom. There were also no encouragements for job well done. After we got married, she has to cope with the pressure of living together with my parents. Again, no encouragements coming from them as well. A person with depression needs a lot of support and encouragement to lift their spirits and share their burden.

4. Socialize
We noticed that people with depression often likes to be alone. They’re often too depressed to socialize and are in no mood to do so. However this is not good for them as when they are alone, all the negative thoughts will just keep on playing over and over in their head. Having good and supportive friends to talk to and share will be helpful. So making an effort to go out and mingle will do a depressed soul good.

5. Last but not least, GET PROFESSIONAL HELP!
Thank God my wife was able to overcome depression without professional help, but I do believe that there are some people out there with more severe cases of depression or they’re just in too deep and can’t find a way out. Don’t be afraid to look for help. There’s nothing to be ashamed off and there are various ways to treat depression. Seeking professional help does not mean that you’re a looser neither should you feel defeated and hopeless should you decided to seek help.

We know that it's not easy coping with depression and sometimes we just don't know how to reach out or help those suffering from it. I hope this little bit of sharing will be able to offer some help or at the very least a glimmer of hope. Below are some links to sites with very useful information.

National Institute of Mental Health

FamilyDoctor.org

Wikipedia

Chasing Rainbows



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Happy (& quiet) 2009 Everyone!!!

Or maybe I just didn't know where to look.

I'm not really the party type so people are probably gathering somewhere I don't usually hang out. It was out about 11.45pm on the 31st Dec 2008 and when I was out and about and it seemed really quiet. Even places like William's and Murni were at best having their weekend crowd. The main roads were also pretty clear. Oh well, not that it matters.

Hopeful Insecurity by Daddy-O
A year flew by in just a blink of an eye,
Some tears of joy and regret still yet to dry.
Success and disappointments edged deeply in my mind,
Wounds that I hope will heal in 2009.
Living in the past will not make me grow,
Bravely stepping forward is the only way I should go.
The Lord's grace is sufficient for me,
And the weak is made strong in the Lord Almighty.
With hope I stepped out, and I pray you will too,
Let us together welcome the year's first morning dew.

Well, break a leg :)

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