Archive for the ‘Tips and advice’ Category

Osteoporosis

August 25, 2007

From what I have read, it seems that the best years to combat osteoporosis is between the years 9 to 20. This is the time when our bones are still soft and pliable and capable of growing thicker and stronger. By the time puberty is over, our bones would’ve more or less hardened and any attempt to strengthen it through calcium supplements would simply come to nought.

In a way, our bone system is like our CPF. Just as we spend a lifetime building up our CPF so that we may draw upon it in our old age, likewise we spend our growing years building up calcium in our bones in order to draw upon it for the rest of our lives.

WHAT A CHILD NEEDS

What your growing child needs to build strong bones (and teeth) are:

1) 4 glasses of milk daily (spread throughout the day)
2) 15 minutes shunshine daily
3) 1 hour weight bearing exercise daily

Items (1) and (2) are easily fulfilled without conscious effort. Item (3) is the critical factor that most people miss out on.

I once saw on TV, a martial arts expert demonstrating his ability to break a thick stack of bricks using just his forehead. When asked how he does it, he says its simply a matter of conditioning the skull through repeated trying.

This illustrates the rationale behind weight bearing exercises. By subjecting the bone to constant impact and pressure, the bone is forced to grow thicker and stronger. Examples of weight bearing exercises are running and jumping, which are what kids do anyway. Swimming and cycling are not weight bearing exercises. In the former, the weight is buoyed by water while in the latter the weight rests on the seat.

WHAT OLD FOLKS NEED

All is not lost for old folks. There are four categories of drugs that are available that supposedly improves conditions of osteoporosis.

1) Evista (raloxifene)
2) Miacalcin (calcitonin) nasal spray
3) Forteo (teriparatide)
4) Bisphosphonate drugs, Fosamax (alendronate) and Actonel (risedronate)

In addition, exercise does help old folks though not in the same way it helps young people. Exercise does not strengthen bones in old folks because their bones have long hardened. What exercise does is that it strengthens muscles which improves balance and prevents falls. Strong leg muscles also help cushion the bone from impact. So for old folks, the opposite is recommended. Instead of weight bearing exercises, they should do more non-weight bearing exercises to strengthen muscles but not impact the bones. So swimming and cycling are recommended for old folks.

NOTES:

Bisphosphonates: Alendronate (Fosamax), risedronate (Actonel) and ibandronate (Boniva) have been FDA-approved for the prevention and treatment of osteoporosis in postmenopausal women. (Alendronate is the only one currently approved for management of osteoporosis in men.) Both alendronate and risedronate are approved for the prevention and treatment of glucocorticoid-induced osteoporosis in men and women. These medications help slow down bone loss and have been shown to decrease the risk of fractures. All are pills that must be taken on an empty stomach with water. Because they have the potential for irritating the esophagus, remaining upright for at least an hour after taking these medications is recommended. Alendronate and risedronate can be taken once a week, while ibandronate can be taken once a month. An IV form of ibandronate, given through the vein every 3 months, also has been FDA-approved for osteoporosis management. Two other IV forms of bisphosphonates available, pamidronate (Aredia) and zoledronic acid or zoledronate (Zometa), are not currently FDA-approved for osteoporosis management.

Calcitonin (Calcimar, Miacalcin): This medication, a hormone made from the thyroid gland, is given usually as a nasal spray or as an injection under the skin. It has been FDA-approved for the management of postmenopausal osteoporosis and helps prevent vertebral (spine) fractures. It also is helpful in controlling pain after an osteoporotic vertebral fracture.

Selective Estrogen Receptor Modulators (SERMs): These medications mimic estrogen’s good effects on bones without some of the serious side effects such as breast cancer. Raloxifene (Evista) decreases spine fractures in women, and is approved for use only in women at this time.

Teriparatide (Forteo): Teriparatide is a form of parathyroid hormone that helps stimulate bone formation. It is approved for use in postmenopausal women and men at high risk for osteoporotic fracture. It is given as a daily injection under the skin and can be used for up to 2 years. If you have ever had radiation treatment or your parathyroid hormone levels are already too high, you may not be able to take this medication.

Strontium ranelate (Protelos): A powder dissolved in water and taken daily, this medication has been shown to reduce the risk for fractures in postmenopausal women. It is currently available in Europe, but not the USA. Because of an increased risk of blood clots, it should be used with caution in women who have a history or risk for deep venous thrombosis or pulmonary embolism.

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Of Plamas and LCDs – bigger isn’t always better

August 19, 2007

A colleague of mine recently told me of the experiences of her good friend, whose contractor had painted her house the wrong colour and was not only asked to repaint the house but also asked to pay for damages. That she says is the power of the consumer.

I recently made a bad television purchase and ex-changed it for another TV. In this case, my colleague says, since I was the one who chose the TV, there was no fault on the part of the shopkeeper and so I had no right to ask for a TV change. Somehow having made a choice, consumer power was lost.

There was clearly consumer disatisfaction in both cases but to my colleague, the former warrants the power of the consumer whereas the latter does not. So to my colleague, consumer dissatisfaction means nothing. The consumer is not entitled to alter his or her choice simply because he or she is dissatisfied. So having entered a restaurant on her own accord and given bad service, my colleague would simply accept the bad treatment than ask for something better.

There are of course vast differences between the first and the second case. When it comes to painting the house, there is nothing complicated that the eye cannot see. A colour is a colour, there is no reason why the consumer would have difficulty seeing a colour as it is, unless she is colour blind. Since colour of a house is so easy to choose, the contractor does not have expert power over the consumer and therefore cannot possibly influence the consumer’s choice.

On the other hand, a television is a complicated purchase and many things are hard to discern even upon scrutiny. For example, how do you know that the colour of a TV is inherently better and not due to settings? How do you know one TV is sharper than the other if they are all playing beautiful images in the showroom? So advice from the salesman becomes important in helping you make a purchase. So does our reliance on the salesman’s advice reduce our final rights as a consumer?

This leads us to another argument by another colleague. Why did I trust the salesman? Why didn’t I do my homework? Why didn’t I ask my friends and fellow colleagues instead?

The salesman is the expert in his field and can provide much information and knowledge that would be difficult for layman like us to acquire. For example, we may have read that plasma TVs respond better to fast motion compared to LCDs. But how much better? Can we see the difference? That’s where the salesman comes in. He tells you to curl your hand into a funnel and focus on one spot on the LCD. When there is sudden and abrupt changes in the scene, you can actually see blurring during the transition where the pixels become reconstituted. This does not happen for plasmas.

You go home and verify the salesman’s advice from Internet sources such as CNet Asia, which are authoritative sources of information. Most websites when making a comparison between plasma and LCD, give the thumbs up to the former when it comes to image quality.

Finally, what about friends and colleagues? The colleague chastised me for not seeking advice from our fellow team mates who all seem to know that LCDs are better than plasmas. But their so-called knowledge turned out to be mere preferences. One colleague dislikes plasmas because of the reflective glass, which I know and don’t mind. Another colleague figures that plasma is an older technology compared to LCD and therfore inferior. But older technology can mean that it is more mature and hence more stable and cheaper. In any case, none of my colleagues knew what I found out eventually.

Be it plasma or LCD, the bigger the screen size, the less sharp it becomes. Websites give it a passing remark, the salesmen do not think it is a problem let alone mention it, even friends and colleagues are bewildered when I say that smaller TVs have sharper images. So who would have suspected otherwise?

It is only when you place a 32″ TV next to a 37″ TV and play the same programme on both would you actually see the difference, especially in the substitles. From the subtitles, you can see that the smaller TV is sharper and more crisp. The difference between a 32″ and a 42″ is even more pronounced.

It is like buying a $5,000 diamond ring believing it would shine brighter than the $2,000 diamond ring you have at home. But lo and behold when you compare them side-by-side, the cheaper ring actually shines better. Wouldn’t you have felt shortchanged spending so much more to buy an inferior ring?