A simple story of my patient in clinic

I saw a patient earlier. At first, I feel weird as he came to the group education before, but he never control his food intake. He seems to have very poor understanding of the diet control on the hypercholesterolemia,

He was telling me that he takes nasi lemak and roti canai quite frequently. I was quite pissed off and disappointed at the beginning, as I felt like my advices are all down to the drain. But in the end, I'm kind of relieved and happy. Well, we cannot easily judge a book by its cover.

I ask this patient why he never follow, he said he had problem to follow, lack of discipline, perhaps. but then I found out that he had limited understanding on the diet control, which mean, he literally did not understand or perhaps remember the diet advises given to him during the group education.

Well, I need to admit that when group education is carried out, it's hard for me to target everyone's need and make sure everyone can follow the flow of it. This patient seems to come from low educational status. That's why he cannot remember or understand whether what he took currently is under controlled or not.

I'm actually happy to find out the reason as he is still coming back to me to ask further about the diet control, even though I need to repeat the whole same thing on low cholesterol diet to him. He was motivated to come back and see me, as he knew he was not doing correctly. He working as a guard in swimming pool and he seems unable to understand thing fast. He cannot recognise many high cholesterol food, not even the common one, like fried food and skin.

However, I'm proud of this patient as he is willing to come back and asked for an individualised diet advises, as he really worried about his own health. He also informed me that he did boxing as his exercise, which is his favourite thing to do whenever he's free during his working hours. Guess he had nothing to much to do while guarding the swimming pool.

Counsel patient is never an easy job, A lot of time and effort needed in order to find out patient's need. As for this patient, I need to explain in the most simplest way so that I can ensure he understands what I am talking about. But I'm proud of him, many patients out there are well educated, but when talking about diet control, they just simply ignore that. This patient can work as a role model for many people out there.

纳豆 ~ 日本食品，也是我最近的最爱！

嗨，大家好。新的一年，新的期望！我今年的期望就是能写好我的部落格，尽快更新。想想我当初写这部落格时，我本身是希望可以好好写下去，好让自己可以保持持之以恒的态度，不要半途而废。之前写了一篇英文版的，现在再来一篇华语版的，可以看得出我的努力吧！

今天和大家分享我最近喜欢上的一种食物，那就是纳豆！可能有些人没看过这个食品，但如果你们有经常到日本餐厅吃东西，那就肯定可以在餐单上找到这个纳豆。

纳豆是一种发酵的黄豆，味道可说是见仁见智，因为不是每个人都可以接受它的味道。基本上和韩国泡菜一样，如果你喜欢，那就会自然而然地喜欢上，如果不喜欢，那就不能勉强了。纳豆是用一些名叫 Bacillus subtilis 的益菌发酵而成的，对身体有益。

我花费了一些时间和精力才在 One Utama Shopping Mall 里的 AEON 才找到。大家可以在冷藏部那里找到纳豆，它和雪糕方在同一区。找到纳豆时真的很高兴，但是同一时间也很懊恼，因为它的种类也太多了吧！加上全都是日语，根本就是很大的难题！

以上两种都是我在 AEON 里买回来的，由于不明白日语，买纳豆时感觉像买彩票，就只能靠猜的。哈哈！！好在买回来时问了问我在日本的朋友，他说这是他在日本常买的牌子，还好没买错，嘻嘻！左手边的纳豆颗粒比较小，而右手边的则比较大颗，这两的包装的纳豆味道也不同。左手边的是普遍的纳豆，里面有酱油和wasabi 酱，而另一个有昆布味的酱油和 wasabi 酱。我个人觉得昆布的比较好吃，因为味道比较浓郁。

打开看看，里面就有我刚才说的酱油和wasabi酱，调味包下面就是纳豆了。吃过纳豆的人都知道，纳豆有一股味道，不是每个人可以接受，打开包装就能嗅到，搅拌后更是浓郁。

打开后就把调味料加入，然后搅拌均匀，拌匀后就可以大快朵颐，很简单吧？搅拌时会产生很多丝，这时纳豆就会变成糊糊，粘粘地。。

以上就是我的分享，喜欢的能自己买回去尝尝，毕竟外面日本餐厅卖的还是贵了点。

P/S : 毕竟不是每个人喜欢纳豆，请慎选！本人就曾经因为介绍纳豆给几个朋友，下场是被骂，因为大家都不能接受纳豆的味道，觉得很臭。

Comeback after CNY!!!!!

Hello, everyone... missing my blog so much. I have been very busy for past few months and only able to visit my own blog after Chinese New Year. This is also my first working day after Chinese New Year, 开工大吉!!!!

How's everyone doing? Still good? Still good after Chinese New Year??? hehe... How many of you have weigh yourself after the binge eating during CNY? Hehehe... For those who have been enjoying eating during CNY, please be careful and face the truth, especially when you notice your clothes is getting tighter after CNY. Please go and check your weight now!!!  :P

Before anyone admits, I would like to confess that I gain 1 kg within 2 weeks time. This is all because of the eating, EAting and EATING throughout my CNY holiday at hometown <crying>. Seriously need to bring it down to prevent further increment. LOL... 

I have my own plan for weight reduction. How about you? 

1. To reduce munching time. 

2. To start back some exercises after resting for so long. 

3. To cook myself so as to reduce my outside food intake.

These are my targets to be achieved, let's see how many of them can be achieved successfully.... LOL.... 

Have you started yours? Better start now before too late, before the 1 kg become 2 kg, before the 2 kg become 3 kg.... :)

I had visited BookFest @ Malaysia 2013 (Popular Book Fair) , how about you???

I went to the BookFest. This time the BookFest has grown as the exhibition area is bigger (that is what I think, well, it is organised once a year, don't really able to remember too much, hehe...)

But there is one thing for sure, which is the crowd of people is still very very huge.. My advice, try to avoid public holiday (Hari Raya) if you can, as the crowd during public holiday will be far more bigger, truly people mountain people sea...

I'm quite lucky as the day when I went there, the crowd is still manageable, at least you are not stuck, but perhaps a little bit of traffic jam there.

According to my past experience, more discount will be given at the end of the BookFest as there might be a need to sell off the books before the books are transferred out of the BookFest. So it is an advantage for them who visit during the last few days of the BookFest. 

Every year, a booklet will be provided when you purchased the entry ticket which cost you about RM2.50 for adult, free entry for those who are less than 18 years old and above 60 years old. Inside the book, all the discounted items are stated and you can go through the book first before aim for the item you want. The special discount on certain day will also stated inside. Therefore, READ it first so that you won't miss out any item that you longed for... 

I bought a few books, yeah, a few, compare to my last visit which I bought A LOT...hehe... 

Some English books and Mandarin one..

All these books have been in my shopping list for quite sometime, but of course, I will waited for the BookFest to get a better price of them, save money is a great knowledge, huh....

Another thing that I'm proud of is the 2 in 1 bag that I bought in the BookFest. This is sold in the stationery section at the 3rd floor. Now, let me show you how my 2 in 1 bag functions.... 

From the first picture, it is a sling bag, colourful and attractive indeed, right? Now let's see how it transforms....

Picture 1

Picture 2

Picture 3

Picture 4

Picture 5

Picture 6

How is it? nice? It transforms from a sling bag into a backpack, so convenient to bring it around, where you can transform it whenever you need. A good TRANSFORMER... LOL....

Well, this is also a discounted item. The usual price is RM 69.90, after discount, guess what, it is only RM35, a 50% discount for the item. Good deal, huh? 

Last but not least, magazines.... I bought 2 English magazine and see how much items given FOC for me? Those are all samples given to first 1500 customers (if I'm not mistaken, can't really remember it, but I'm sure this is first come first serve basis...)

The magazines are only RM6 and RM8 each, but the free gift given is far more costly than the one I spent, another good deal... LOL...

This is my shopping in the BookFest, how about yours??? Visit it from 3rd August till 11th August, don't miss it!

BookFest @ Malaysia 2013 第八届海外华文书市

Hurray.... First, I would like to welcome back BookFest @ Malaysia. One of my favourite event of the year!

BookFest will be held on 3rd till 11th August 2013. The venue will be at Hall 1 to 5 (Ground Floor) Grand Ballroom & Banquet Hall (Level 3) , Kuala Lumpur Convention Centre KLCC and open from 10am to 10pm.

Further information can be obtained from http://www.bookfestmalaysia.com/index.php

I went there twice and it is really a good place to visit. Lots and lots of books and stationeries are available. Most important thing is that you can get very cheap price for your favourite book.

I already have the shopping list with me.
See you there!

Is Milk Tea a healthy drink???

I believe all of you might be thinking, milk tea is fatty and unhealthy, why dietitian still taking? Haha... Well, first, dietitian is also normal human being like you all do, so dietitian still taking bad food. 

Milk tea can be found in many variety, such as Teh tarik (famous drink for Malaysian), Taiwanese bubble tea and Hong Kong style milk tea (this is obviously Hong Kong's famous drink, hehe.... ).

The main ingredients of preparing all these milk tea are creamer and sugar. Of course, these are very fattening and unhealthy, but if you are drinking teh tarik, teh si and yuanyang (鴛鴦) everyday, this drink does not make a difference from all of the drinks that you took on daily basis.

The good thing is, dietitian might be a little bit more health concious in which you will know how much to control when you are taking unhealthy food. Moderation is the key point here. If you know these is unhealthy but at the same time irresistible, try to limit your intake, don't take it too often, and you may ask for lesser sugar for the drink itself as well. If not, try the flavoured tea instead of milk tea, at least you are able to cut down on the creamer intake. Creamer is bad for cholesterol!

I always tell my patients, friends and family, it is impossible to ask you to avoid taking unhealthy food, but you can always cut down the amount and control on the food which is bad for you... 

My new shoe... Scholl

Lastly, I bought my shoe!!! Found my shoe size in Paradigm Mall... I can wear my new shoe for work now. Come and have a look on my new shoe... 

How it looks? I know the pattern is not attractive as the usual one that we usually shop outside, but that's all they have in Scholl, what to do? Just try to bear with it. Anyway, I'm looking for shoe to protect leg and knee, not shoe that just look good but bring you pain... In fact, this shoe seems similar with my old Scholl shoe, guess they don't have much choices there. 

All of the Scholl shoes are specially meant for leg and knee protection. Mine got arch support for the insole, good to wear, allow you to stand and walk for long time while giving comfort to your legs. 

Still remember the orthotic insole that I bought last time before I'm able to get my new shoe? I'm no longer using that now, but I'll put them in my other shoes so that it still provide its service. Hehe... 

My favourite shoe ~ Scholl

Dietitian needs to stand and walk a lot, especially when you are working in big hospital. I have been suffering from leg pain recently. Guess it's time to change my shoe. 

I started to use Scholl shoe since I worked. A pair of nice shoe to give you comfort and protection. However, I still having leg pain, may be the shoe had served me for too long ( I guess about 1 1/2 year ), it's time to give it a rest already.

Initially I was planning to shop for the shoe, but the shop didn't have the size I want. Then I started to check on the biomechanics thing at shelf. 

The full name is biomechanics heels and knee pain reliever. They have different type of the orthotic insole for better cushioning and foot support. Different biomechanics range serve different purpose and different protection, but mainly to reduce the pain and stress on foot region. 

The one I bought is 3/4 length orthotic insole. It's easy to be used, just put it inside your shoe and you are ready for your walk. It's available in 3 sizes, which is small, medium and large, make sure you get your exact size so that it can fit your foot well.

This is how it looks like, cute isn't it? Just put inside your shoe. Well, the cushion in my own Scholl shoe is actually flatten out already since I wear it most of the time. Before I'm able to get my new shoe, I guess it's better to get something as a replacement at this moment, I don't really able to stand the pain whenever I walk too much. 

This is what it does to help reduce pain and soreness of foot. Not bad huh???

Well, this biomechanics is just something to be use temporarily until I'm able to get the shoe I wanted. At least, it fits into all type of flat shoe... 

Again, it's time to shop for shoe.... huh... 

Enquiries About Dietitian

I'm back after so many days!!!

I received an email from a reader few days ago and I would like to share the information for all those who needed it. Thanks for the email, Ester. 

Here's the email : 

I saw your blog while I'm searching information about dietetics course.I would like to ask you some question about dietician..I hope you don't mind to answer my question...

1.What is the salary range of dietician for fresh graduate and experienced dietician?

2.Does the job opportunity for dietician wide for nowadays in our country?

3.Is it hard to get the dietetics course for local university like USM,UKM?

Answer : 

I think those are the popular questions for many of you out there, right?

Salary might varies, depends which sector you are in, either government or private hospital. For the salary range, if you work in government sector, the starting salary is about 3k, depends whether you are working in town area or not. For private sector, the starting salary might be a bit lower, but I heard the increment can be fast, besides, private sectors might paying bonus as well, so that's actually increase the amount of salary in general. Salary for fresh graduates and experienced dietitian will definitely be different. For dietitian, experience is very important, more experience means more salary. I believe this happens in all different job as well. 

Job opportunity can be a lot depends what you want to be. Dietitian is expanding day by day now, as announced by our health minister last time, they plan to get dietitian for all hospitals in Malaysia. Dietitian is more and more recognised currently, almost all hospital needs dietitians. Government also allocates dietitians in clinic (klinik kesihatan) in many districts. If you are not so interested in clinical dietitian, you can pursue in many different job which need diet and nutrition advices. 

I'm not sure whether it is difficult to get dietetics course in local universities, but definitely better results have better chances. As I know, dietetics can be one of the popular course for biology students. So, my advice, try to achieve better results so that it eases you to get into any of your favourite courses. 

Thanks for writing to me, hope you enjoy reading my blog.

饮食治疗师的意见 - 罗马不是一天建成的

我没去过罗马，但我看见了罗马的宏伟。。。

《罗马不是一天建成的》，相信大家都听过。。可正真明白它的意义的，又有多少人呢？

在医院工作，能让人见识更广，在医院看见的事物也很多，仿佛所有的人生情景都在医院上演。

想想也是，在医院都逃不过生老病死，婴孩出生时、生病住院时、受伤住院时、年老多病时、临死边缘时、人生末路时等等。

每当开始教育一些三高（高血糖、高血压、高胆固醇）病人有关饮食的控制时，都会听到很多的借口，例如：

1。 我已经活了几十年，哪可能这么容易就改得了几十年的习惯？

2。人生短短几十年，要控制饮食，岂不是没有了人生乐趣？

3。不是你需要控制饮食，你可说得倒简单。

各式各类的借口都可以从病人口中说出，可能疾病缠身，心情不好，说话也就不分轻重了吧？

其实应该要想想，罗马不是一天建成的，身体会变差，三高会出现，也不是一天造成的。这都是一点一点、长期的不均衡饮食习惯所导致而成的慢性疾病。

疾病不是一朝一夕的事情，尤其是三高的问题，所衍生出来的后果是你所想像不到的。

高血糖的情况通常来自于长期过量的糖份摄取，以至于产生各种并发症，例如：眼睛血管问题，视网膜病变 (retinopathy)，肾病 (nephropathy)，神经系统的问题 (neuropathy)，等等。

高血压的形成通常来自于过量的盐份摄取，而高胆固醇则因为过量的油脂摄取，导致血压升高，血管硬化的问题，一并提高病人患心血管疾病 (cardiovascular diseases) 的风险。心血管疾病包括了心脏病，心脏阻塞，中风等疾病。

大马以美食著名，但也由于大马人长期营养过剩的饮食习惯，大马的慢性疾病的成长率也跟着增加，三高的情况越来越普遍。

三高的问题是日积月累得来的，那如果要控制饮食也不是一朝一夕可以做成的。控制饮食也需要时间，以让体重能慢慢下降，改善三高、慢性疾病的问题。

如果有病人说：我已经活了几十年，哪可能这么容易就改得了几十年的习惯？，那我只想对他说：你的问题纠结就是因为几十年的饮食问题所造成的，如果还想多活几十年，饮食改变是必定的，罗马不是一天建成的，几十年的问题，当然需要几十年的时间解决，请不要妄想能迅速达成！

不过，到目前为止，我还不曾这样跟病人说，因为这样说好像有点调侃病人的感觉，嘻嘻！