These days, the standard of living has improved greatly and so people are living longer and enjoying their golden years. However, some people relate aging with being unwell, which is not true. However, the most important thing is that quality of life should not be dwindled in any case. Humans are blessed with bodies that can last long to over hundred years, but with aging the ever increasing physical, mental and chemical stress compels the body to weaken up and get prone to several diseases.

According to scientists who study aging (Gerontologists), people can live gracefully at their growing age only if they are living a stress-free lifestyle, which seems quite complicated. There are several people who wish to live a healthy lifestyle in their golden years for which they tag along various secrets to optimal health and do not require any surgery or drugs.

These days, more and more people have started realizing the value of keeping in top form but what is the missing link that can connect humans with healthy bodies? The answer is Chiropractic Care. Confused! Only a chiropractor is trained to detect subluxations and correct them.

Sounds more complicated, isn’t it? Ok, to put in simple words, Chiropractor is a spine and nerve specialist who is trained to perceive any kind of misalignment in the spine. This misalignment is referred to as subluxation which actually pressurizes the nervous system including brain, spinal cord and nerves; and these results in low health conditions.

Most aged people suffer from long standing subluxations that usually arise in early stages of life and if not detected or corrected at appropriate time can lead to serious circumstances. This is the reason that these subluxations are also referred to as “SILENT KILLER” and lower the health prior to showing any symptom. If the nervous system functions properly, that is, chiropractic aspect is taken care properly, people can gracefully live their aged years.

Chiropractic care staves off the body from spinal and extremity pain, circulatory disorders, constipation, depression, osteoporosis, joint stiffness, muscular spasms, risks of falls and injuries and many other ailments. So, if you also wish that at your golden years you should not be hospitalized for being suffering from several ailments, start focusing at Chiropractic Care now and maintain optimal health.

There will be no symptoms till the fourth decade. Initial symptoms may be palpitations due to irregular heart rhythm and breathlessness on exertion. Those symptoms may eventually develop to swelling of legs, cough with frothy blood stained sputum, and even stroke due to clot formation of heart.

Once symptoms occur, it is important to perform imaging on the heart to plan for treatment. If the valve stiff due to deposit of calcium salts, surgery is recommended. Alternatively, PTMC (Percutaneous Transvenous Mitral Commissurotomy) or balloon valvuloplastry, is a semi-invasive procedure where a balloon is used to dilate the narrowed mitral valve.

How is PTMC done?

This procedure can only be carried out through the groin approach. Both the femoral vein and artery will be punctured and one sheath will be inserted through each vessel. A long pigtail catheter will be positioned in the left ventricle the same way as a coronary angiogram. Then a long puncture needle will be placed at the right atrium through the femoral vein. A long coil is then passed to the left atrium through the hole punctured. A balloon-tipped catheter (Inoue balloon) is then guided through the hole created to the left atrium and from there passed through the mitral valve.

The Inoue balloon is inflated several times to stretch the narrow segment of the mitral valve. The entire balloon, catheter, coil and other foreign bodies will be removed. The hole created will usually close off by itself. Even if it is not sealed, such a small hole shouldn’t cause any problem to the heart. Patient will need antibiotics before and after the procedure.

Dental implant is a sophisticated titanium screw that replaces the root portion of a missing natural tooth. The implant is placed in the bone of the upper or lower jaw, allowed to bond with the bone, and would serve as an anchor for the replacement teeth. These replacement teeth look, feel and function exactly like natural teeth. This is one time that the clinician can make something for a patient that is as good as the original.

Dental implants, if taken care of, can last a lifetime.

The surgery takes about 20 minutes. Local anesthetic is administered and a gum flap is raised to allow access to the underlying bone. The bone is then gently prepared with a series of drills which create a channel for the implant to be inserted. A period of 10 to 12 weeks is necessary to allow the bone to fuse to the implant. In reality, it is even less painful than extracting a tooth.

Benefits of dental implant

• Dental implants can prevent the collapse and aging of lower face. Unlike bridges, which require adjacent teeth to be trimmed and which need to be replaced every 10 to 15 years.
• Dental implants will not interfere with speech, there will also no problems to chew food, especially the meat.
• Patients often find renewed confidence and an improved sense of self-esteem.

Improve skin texture and appearance

• Microdermabrasion, also known as “lunchtime” treatment can effectively diminish age spots and light acne scars by gently exfoliating the skin’s upper layers and simultaneously removing the dead skin.
• Laser skin resurfacing is effectively in removing the outer layers of the skin that are damaged or unevenly pigmented. This procedure will help to stimulate the production of collagen and new skin cells in the underlying layers of skin.

Look younger and wrinkle-free

Facial fillers work by filling in folds and “plumping” up the sunken facial areas. Those who are troubled by crow’s feet, frown lines and furrows in the forehead can now turn to Botox injections to help reduce wrinkles and smooth out fine lines.

Zip off those zits

Acne light therapy has emerged as an effective treatment to significantly help clear acne while cleansing the skin pores. It targets and kills bacteria that are responsible for acne outbreaks.

Tighten & lift up saggy skin

Radiofrequency (RF) is a popular non-surgical skin tightening treatment that can help firm up the skin and improve the contours of the face and neck. The aesthetic improvements are achieved with a radiofrequency device that is passed over the face, with the tip in contact with the skin’s surface, to help to stimulate collagen development.

Achieve a firmer facial profile

Neck is an area that tends to accumulate fat that is hard to lose. Fat deposits in neck can make a younger person seem older and a fit person seems out of shape. So, liposuction, a surgical procedure can be carried out on the neck area. Doing this will reduce fat deposits and firm up the skin and improve facial profile.

Acupuncture for skin revitalization

Acupuncture is gaining in popularity as one of the alternative methods to help replenish the skin, erase lines and delay the aging process. It helps to build collagen tones muscle, improves circulation and moistens skin without the risk of skin pigmentation or scarring.

Botox treatment lasts for three to six months. Lines and wrinkles gradually reappear as the Botox wears off. With repeated treatment, doctors have observed that Botox may last longer as the muscles become less prominent from non – use.

The most common side effect of this treatment is temporary bruising. You may also have a temporary headache. If Botox spreads outside of the muscles being treated, there may be temporary eyelid drooping in a small percentage of patients. This is why the doctor will ask the patient not to rub the treated area for several hours and not to lay down for a few hours.

However, Botox should not be administered to patients who are pregnant, are breastfeeding, or have a neurological condition. Botox cannot be used on all types of wrinkles it important to have a detailed consultation with a doctor before proceeding with treatment.

In PART 2 of our look at the symptoms and risks associated with heart attacks, renowned cardiologist Dr Michael Lim Chun-Leng, who is the Medical Director of the Singapore Heart, Stroke & Cancer Centre and Dean of the College of the Asian Pacific Society of Cardiology discusses various ways in which you can minimise the risk of developing heart disease.

Q. What factors can help patients reduce the risk of a heart attack?

Diet: The key is to enjoy a sensible diet and eat in moderation. Eat from a wide variety of food – increase intake of complex carbohydrates (rice, potatoes and whole-grain bread) as well as fruits and vegetables. At the same time, reduce consumption of fats, sugar, salt and alcohol. It is also important to drink a lot of water.

Exercise: Exercise is good for the body in general, but it is important not to over strain yourself, especially if you are in your late 30s or 40s. Personally, I would recommend 30 minutes of brisk walking three to four times a week as a relatively safe form of exercise. This helps to keep the body mobile without placing too much stress on the joints.

Regular Medical Review: Regular medical review by the family doctor can aid in controlling risk factors and maintaining a healthy lifestyle. At the same time, it may also mean quicker detection and earlier treatment of other possible ailments.

Q. What about health supplements? Can they help prevent heart disease?

There are many health supplements which claim to have heart attack prevention properties. However, a study in the New England Journal of Medicine showed that there was no difference between people who took these Vitamin B supplements and those who did not in terms of their chances of developing heart attacks. Hence, it would be wise not to buy into these claims unless they are accompanied by results from proper research trials. The only supplement which has data to show benefit is fish oil.

Q. What drugs are used in the prevention and management of coronary heart disease?

The entire group of statins are the primary drugs used. Study results clearly show that patients who had never suffered from any heart attacks, but had elevated cholesterol levels and were treated with statins had a lowered chance of suffering a heart attack or stroke. As technological advances in medicine gradually allow early detection and prevention, medicine will shift from treating diseases to the prevention of disease. The other major group of drugs are the anti-platelet drugs such as aspirin, ticlopidine and clopidogrel. They are used to prevent clot formation when a cholesterol plaque in the heart artery ruptures. Clot formation in the heart artery can result in occlusion of the heart artery and can cause a heart attack.

Q. What are the side effects of the drugs?

Studies have shown that out of every 1000 people who take statins, only about four would develop some elevation in their liver enzymes. One in 10,000 may develop slight elevation in their muscle enzymes. Severe elevation in enzymes is extremely rare, probably only one in a few million patients would suffer from this.

Looking after your make-up.

Different products have different expiry dates. In general, if the make-up changes in colour or smell, of if the liquid foundation separates out, don’t use the make-up.

There are some general guidelines from industry experts on time limits for certain types of make-up however, they have not been supported by clinical studies.

• Foundation: 1 year after opening, 2 years if not opened

• Eye Shadow: 1 year after opening, 2 years if not opened

• Lipstick: 18 months after opening, 2 years if not opened

• Mascara: 2 months after opening, 1 year if unopened

In general, keep your products in a cool, dry place – not in your car or under the sun!

Sharpen your make-up pencils regularly and always cover the heads to keep them clean.

If you use make-up brushes, clean these at least once a month by washing with soap and water, or even with shampoo. Dry the brushes thoroughly before use.

Should you share make-up?

Sharing make-up increases the risk of getting infections. These include spreading of conjunctivitis (pink eye) from sharing eye make-up and mascaras, to cold sores caused by herpes simplex virus from sharing lip products.

This includes using samples at make-up counters. Make sure that the product has been cleaned and that appropriate disposable brushes or applicators are used by the counters before you try the products.

Chemicals, make-up and you.

Cosmetics sold in Singapore are registered with the Health Sciences Authority which ensures that potentially harmful ingredients are not present.

Although studies show that true make-up allergy is not common, 4 it is important to realise that there are components in make-up which can irritate the skin in certain individuals.

The most common components of make-up (or even skincare products) that lead to allergies or irritation are fragrances and preservatives.4

If you are having a reaction to a particular product, discontinue use but don’t throw it out, bring the product and the ingredient list when you see your doctor.

Permanent make-up.

There is always a risk of a reaction to eyelash or eyebrow tinting or to the application of lip liner tattoos. There have been reported cases of irritation leading to inflammation granulomas (small reactive bumps around the area) to lip liner and eyebrow tattoos.5

In addition, reactions to eyeliner tattoos have been reported and such allergic reactions have required surgery to remove the tattoo pigment.6

Allergic reactions have also been reported with eyelash tinting which have resulted in loss of eyelashes in some individuals.7

If you are considering any of these procedures, you may wish to ask the artist to do a test spot on your skin first to check for allergy or sensitivity.

References

4 Biebl KA et al. Allergic contact dermatitis to cosmetics. Dermatol Clinics 24, 2006: 215-232 lbid iv.

5 Martin JM, et al. Granulomatous reactions to permanent cosmetic tattoos successfully treated with topical steroids and allopurinol.J Cosmetic Dermatology 2007 6(4): 229-31.

6 Vagefi MR, et al. Adverse reactions to permanent eyeliner tattoo. Ophthal Plast Reconstr Surg 2006 22(1): 48-51.

7 Bhat J, et al. Xanthelasma palpebrarum following allergic contact dermatitis from paraphenylenediamine in a black eyelashtinting product. Contact Dermatitis 2003; 49(6): 311; Wachsmuth R, et al. Loss of eyelashes after use of a tinting mascara containing PPD. Contact Dermatitis 2006; 54(3): 169-170.

The writer is the medical and scientific director at Cutis Medical Laser Clinics at 81 Club Street, Telephone 6237 9700 (formerly known as Dermacare). She is a Harvard trained epidemiologist and is US board certified.

Q. What kind of symptoms indicate an imminent heart attack?

Shortness of breath on exertion, chest tightness or chest pains often precede a heart attack but in reality, many of these patients present with these symptoms only when they are about to have a heart attack. Such symptoms occur when more than 70% of your arteries are clogged up. However, studies have shown that the majority (two thirds) of heart attack patients have only a 40% to 60% diameter narrowing of the heart arteries and do not feel any chest pains until they get a heart attack.

Q. How does advanced technology help with heart disease?

In the last few years, technological advances have made it possible to take X-ray pictures of the heart arteries in three dimensions without the need to put a tube into your body. In the past, the usual non-invasive tests such as treadmill testing, stress echocardiography and nuclear perfusion scans have been used to screen for blockage of the heart arteries. But they can only detect patients with severe blockage, and even then, for those with severe blockage these tests can only pick up 70% to 90% of these patients. Today, CT angiogram of the heart arteries allows us to visualise the arteries within seconds in a safe and non-invasive manner. This test is a painless outpatient X-ray scan. Its greatest advantage is that it will allow doctors to make a more accurate diagnosis and begin earlier treatment of heart disease.

Q. Who is at risk of a heart attack?

The main risk factors are high cholesterol, high blood pressure, diabetes mellitus and smoking. Men, older people, and people with a family history of stroke and heart disease, tend to face a higher risk of cardiovascular disease.

Q. How often should a screening test be taken?

Patients should see their family doctors for annual assessment and to control risk factors. For those who have had a CT angiogram of the heart arteries, it is usually unnecessary to repeat it for at least another five years.

To be continued…

PART 2 will include more make-up tips and will be posted on Monday.

There is nothing more effective than a good make-up touch-up to improve your self-esteem. Numerous studies have documented an improved quality of life with the regular use of make-up, particularly in individuals with skin conditions.1

Furthermore, in a study evaluating whether cosmetics enhance attractiveness, both men and women rated the use of eye make-up as having a marked impact on facial attractiveness.2

Understanding that attractiveness has a positive impact on mood and well-being, suggests that regular make-up use may be beneficial. But how do you choose between the hundreds of make-up brands that are available in the market today?

Your skin and make-up.

Make-up colour selection is an art. It’s primarily a lifestyle choice rather than a medical opinion. However, consider the following points in using and choosing make-up.

Most make-up is safe when used properly although some individuals may be sensitive or allergic to certain components of make-up.

Less is more. Try not to overload your make-up and skincare schedule. Talk to your doctor about the types of skincare products which will suit you.

Consider using mineral make-up as it contains natural minerals which provide benefits such as sun-block. Also mineral make-up may be less likely to irritate the skin as it does not contain talc or oral fragrances/preservatives.

In choosing a mineral make-up brand, look at the ingredients. It should include protective minerals like titanium dioxide and zinc oxide, but it shouldn’t include talc.

Finally, when selecting a foundation, make sure that it matches your skin exactly – this is more practical rather than medical advice! The aim should be unobtrusive, flawless coverage without tide marks around the face.

Take care of your skin.

Have a good skin care regimen that suits your skin before you put on make-up. Use a broad-spectrum sun block with a minimum SPF of 30 to make sure that your skin is protected from harmful UV rays.

If you have an active inflammation, whether it’s due to acne or skin sensitivity, be particularly careful in applying make-up. Mineral make-up contains ingredients that may actually be anti-inflammatory reducing the redness and irritation.

Always remove make-up and cleanse the face before going to bed. Cleaning the face removes dirt and bacteria on the skin surface. Avoid using soap-based cleansers as these increase skin pH and may affect the skin barrier.3 Non-soap based cleansers are gentler, with minimal change to skin pH.

To be continued…

1 Korichi R, et al. Why women use makeup: Implication of psychological traits in makeup functions. J. Cosmetic Science 2008 Mar-Apr 59(2): 127-37.

2 Mulhern R, et al. Do cosmetics enhance female Caucasian facial attractiveness? Int J of Cosmetic Science, 2003, 25:199-205.
3 Kuehl BL, et al. Cutaneous cleansers. Skin Therapy Letter 2003; 8(3):1-3.

HT: Does the treatment hurt?

DL: For most people, chiropractic adjustments are painless. Some people who are new to chiropractic adjustments may involuntarily stiffen or resist the adjustment and feel a small amount of discomfort until they are able to relax during the care. In addition, mild discomfort may be felt if the person had a recent trauma, such as whiplash or a lower back injury, due to inflammation. However, many people report a feeling of relief, calmness, and a sense of well being after the adjustment; others feel improved mobility.

HT: What is the “popping” noise often heard in an adjustment?

DL: When your vertebrae are adjusted, tiny pockets of gas are released from the joints, making a “popping” noise. It’s the same sound you hear when you pop your knuckles. Not all people hear this noise and not all adjustments create this noise. It’s not a sign that the adjustment is or is not working.

HT: When should a person visit a chiropractor?

DL: People like chiropractors because they approach healthcare in a unique manner. Instead of diagnosing and treating disease, your chiropractor’s purpose is to enhance your health by analysing your spine and eliminating your vertebral subluxations. Without subluxations, your body and mind have the ability to function better, heal better, and you feel better. So you don’t need to have a particular complaint to see a chiropractor. Throughout your life, you have your teeth, blood pressure and eyes checked – an examination by a chiropractor to check for the earliest possible presence of subluxation might be one of the most important check-ups you and your family have in life, because everyone needs a healthy spine.

HT: How often can a person visit a chiropractor?

DL: How often a person decides to benefit from chiropractic care is always up to them. The chiropractor will give a person their best recommendation to achieve their optimal state of health and then recommendations on how to maintain their optimal health for their lifetime. The true purpose of chiropractic is not as a treatment of aches and pains but to rid your body of subluxations so you are better able to adapt to life’s stresses. That’s what true health is all about. That’s why some people who choose a chiropractic lifestyle report better quality of life, improved physical health and emotional health, less perceived stress and drugs in their lives and more energy, vitality and enjoyment.