Category Archives: Wellness

REFLECTIONS – All I Want For Christmas Is A New Right Breast

Hwee Hwee Laurence has a wish –

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On 10 December 2013, Jean-Claude Mas, the founder of the company Poly Implant Prothèses (PIP) that made defective breast implants not conforming to medical standards, was judged in court in Marseille.  He was condemned to four years’ imprisonment, fined 75 000 Euros and not allowed to work anymore in medical-related fields.

I suspect I was one of the last people implanted with a PIP because just two months after having the mastectomy operation, I received a letter from the hospital informing me of this.  The ‘re-shock’ was almost too much to bear.  And of course, over the following months, the hullabaloo over this scandal was reported almost daily in the news and it certainly was not good for the morale especially when one was undergoing chemotherapy.

You might ask – why did I have an implant in the first place?  Am I so vain about keeping my breasts?  Or did my husband want me to have an implant?  The answers are ‘No’.  I never wanted an implant or any breast reconstruction.  My husband’s only aim was that I get well, and if he ever mentioned the possibility of an implant, it was because he was concerned that I might be psychologically ‘disturbed’ by my asymmetry.

I had an implant because every one of the doctors I met related to my cancer strongly advised that I should.  At that time, I had the impression that feminity is an important aspect for French women since at first,  nobody could believe that I really did not want an implant.  ‘You are still young!’ they said.

So why did I give in?  I did so because I did not know otherwise.  I had never had cancer or a mastectomy, never knew what it would be like to be flat on one side nor what it would feel like to have an implant.  In the end, shouldn’t doctors know best?  Which is why I wished that, because they knew better than me, they had fought harder to stop using PIP implants once problems started, not continued to do so until the last few months before ‘higher authorities’ decided against it.

I have been advised to remove, no – to change – the implant.  So far, I have not plucked up the resolve to go for another operation.  Also, I have been considering not having a new implant.  But then, I am now so used to having it that I am scared to have to readjust to being asymmetrical.

The one thing I have learnt from all this is – let’s not cry over spilt milk (or silicone – ha ha!).  I could have regretted listening to the doctors, but then without an implant I could have hated my lopsided body, too.  I can continue to rave and rant at Monsieur Mas but what good would that do to my health?  Better to just let go and get on with life.

My annual check-up is coming up soon and I will have to make a decision by then.  So maybe – a new right breast would be what I will be getting this Christmas.

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FOOD – Milky dessert

I’m not lactose-intolerant – rare among the orientals, thanks to my mum feeding me copious amounts of milk right into adulthood. Sadly, my 23-year-old son has problems digesting lactose but tolerates cheese better than milk. Even now I have milk in the morning and at night, but low-fat of course. And yet, a bone scan indicated osteopenia – sigh.

There’s lots of controversy regarding the healthfulness of dairy but those of us who love our milky beverages, ice cream, clotted cream, Brie, paneer and so on are loath to give it up even if it’s believed to be mucus causing.

When I received a 2-litre pack of F&N Magnolia Lo-Fat Hi-Cal Milk, I glugged down half of it and used some to make puddings. With mango and evaporated milk, you get the consistency and taste of the mango pudding served in Chinese restaurants. But to lower calories, substitute low-fat milk for much of the evaporated milk.

If you use only low-fat milk, maybe you can get something that resembles a very light panna cotta. Panna cotta fans will laugh with derision – we know panna cotta requires heavy cream which accounts for the rich smoothness, but dieters can’t be choosers.

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FRUITY Pudding

10g agar powder

100g sugar

600ml water

1 punnet strawberries or 3 ripe mangoes, puree half, chop half

250ml evaporated milk

Method

  1. In a medium saucepan, mix the agar and sugar with 500ml water. Bring to a gentle boil over low heat, stirring constantly.
  2. Gradually add evaporated milk, stirring until well blended. When the mixture starts to boil, turn off heat and add fruit.
  3. Pour into rinsed jelly moulds.

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Lo-Fat FRUITY Pudding

10g agar powder

100g sugar

300ml water

1 punnet strawberries or 3 ripe mangoes, puree half, chop half

100ml evaporated milk

450ml low-fat milk

Same method

RECIPE – Never a dhal moment

A photographer I once worked with asked “Is it boring?” when we kept referring to a dish as a dhal (dull) curry. On the contrary, dhal or lentils make such yummy dishes that even my carnivore husband takes second helpings when dhal is served.

Cynthia Wee-Hoefer, one-time colleague and now organic farmer (the Hoefers grow vegetables in Nepal) wrote in her Organic Himalaya November email Update: “Today’s lunch was reheated Nepali lentil soup that we had frozen from the last batch made for Farmers’ Market. We embellished it with chopped mushrooms, diced carrot and diced turnip and filled bowls of hearty goodness and sublime flavours with a hint of fennel seeds, coriander, turmeric and onions.” For more info, visit http://www.bodywithsoul.com/organic_himalaya.php

Doesn’t that sound deliciously warm and comforting?

Lentils are cheap, nutritious and versatile. There’s such a variety and they can be served in stews, soups, with salads or as spreads. The high fibre helps stabilise blood sugar and with 26% of the calories attributed to protein, and the high iron content, it can help us live healthily without hurting animals. 

I like my dhal with a generous dollop of yoghurt – looks messy but tastes heavenly. With the increasing number of diabetics in Singapore (and elsewhere), we would do well to switch to complex carbs and low-fat but satisfying ingredients that don’t leave us famished after a while and craving cookies and crisps. As someone who is mesmerized by chocolate, cake and salty snacks, I know how important it is to feel full enough to resist the tasty offerings passed around the office, or calling my name in food malls.

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Here’s a dhal dish from the Indian Vegetarian Cookbook by Prava Majumder and Sumita Sen-Gupta published in 1989 by Times Books International (now Marshall Cavendish). I have fond memories of working with Mrs Majumder whose recipes were featured in the magazine I then worked at. Make a big pot of this sambar and freeze in batches to savour whenever you want something simply good.

 

Dhall Sambar

Serves 6

Prep: ½ hour, Cook: 1 hour

Kcal per serving: 347

Ingredients

2 teacups arahar dhall (use any small lentils)

2 teaspoons salt

2 teaspoons turmeric powder

½ cup sliced white radish

½ cup sliced eggplant

½ cup sliced okra

½ cup sliced drumstick (optional)

½ cup sliced carrot

½ cup sliced cauliflower

4 Fresh green chillies

2 teaspoons chilli powder

2 teaspoons sugar

2 tomatoes, halved

2 tablespoons oil

4 dried red chillies

A few curry leaves

1 teaspoon mustard seeds

2 teaspoons chopped ginger

2 onions, chopped

1 tablespoon tamarind juice

Method

Wash dhall and then boil with salt and turmeric powder. Cook with saucepan covered.

When dhall is half-cooked, put in all the fresh vegetables except cauliflower, green chillies and tomatoes.

When vegetables are three-quarters cooked, add cauliflower, green chillies, chilli powder, sugar and tomatoes. Remove boiled mixture from fire when cauliflower is half-cooked.

Heat oil in a pan and fry dried red chillies, curry leaves and mustard seeds till they pop.

Add ginger and onions; fry till light brown. Add the cooked dhall and tamarind juice; leave to simmer for a few minutes before removing from fire.

Serve Dhall Sambar with plain rice.

WELLNESS – Lavender’s blue, dilly dilly

For mouth ulcers, dab 100% pure lavender essential oil. I was bothered by a painful ulcer for 10 days. Bonjela and Difflam Mouth Gel did not help. I was advised to apply salt but no way was I going to subject myself to more suffering. My colleague suggested lavender oil. I happened to have a bottle of Young Living lavender oil but any reputable brand will do. It goes on painlessly but the taste isn’t great. The effects were almost immediate and the ulcer was gone in two days.

WELLNESS – Here comes the sun, and it’s not alright

I’m looking forward to a break in Penang with my girlfriends next weekend. We’ll be staying at the Golden Sands Hotel right on the beach which sounds fabulous but with my hyper-pigmentation, it means taking cover under umbrella and beach hat, and avoiding the outdoors at high noon.

 

I’ve been using Heliocare sunblock on my face for a couple of years, but it’s too precious to slather all over my arms and any other exposed skin, so I will have to shop for sunblock for the body. The problem is finding something effective and not icky-greasy. A safer option is sunblock that works from inside. Heliocare has a supplement, but the bother is going to a clinic to buy it (check the distributor’s website for addresses – www.neoasia.com.sg)

 

Sun damage is often not taken seriously until it shows up as blotches and wrinkles, and by then you need to be prepared to spend a fair it of money to repair it. The problem with topical sunblock as Dr Victor Wee of Kin Mun Clinic says, “We have found that direct sunlight will go through the best sunblock in the world”, so how do we protect our skin I asked Dr Wee? (The good doctor obviously takes good care of his skin – he’s a father of 3, and a grandfather of 13!)

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When buying sun protection products, what should we look out for? How do we know what will work?

When buying sun protection products, try to get one with a good SPF, preferably SPF 50 plus. Be careful of sunscreens that are too oily and that can clog pores especially if you are acne prone.

I know that everyone recommends SPF 30. However to get this level in the lab we have to slap on a certain thickness which is not realistic

So I would personally recommend the use of Heliocare SPF 65 sunblock which will give you a protection of at least SPF 30. I personally use a non-oily base and apply it often in a day without worrying about blocking my pores.

 

Are there foods that will help protect against sun damage, and repair damaged skin? How much or how often would we need to consume these?

Eating fatty fish such as salmon, cherries, pomegranates, and drinking green tea help protect against sun damage because of the antioxidants they contain. However, more importantly, one should avoid direct sunlight, using a hat or umbrella, especially in hot countries like Singapore.

 

On a supplement like the Heliocare Pure White Radiance whitening supplement, how long can people expect to wait before seeing results?

From our experience, results are seen after a period of 3 months, but some patients actually see an improvement in uneven skin tone after a month. Lightening and brightening of skin is also reported after a month. The supplement is halal certified, so it’s suitable for all.

What is the advantage of Fernblock v the ingredients used in most commercial sun blocks?

 

Dr Thomas Fitzpatrick, discovered that Fernblock can prevent as well as lighten pigmentation, and to stimulate collagen and elastin, thus having the ability to firm up aging skin.

 

How high should we go with SPF? Some friends say their doctors put them on SPF 90.

For outdoor sports even higher than that would be good provided it suits your skin. For golfers and joggers I use SPF 100! Again for the same reason that nobody slaps the required thickness of sunblock.

I also remind patients that no matter what claims are made on the duration of effectiveness, studies show that after 2 hours we need a fresh layer of sunblock again. So on holiday, jogging or golfing just have to reapply every 2 hours; plus of course your hat to cut off direct sun on your face.

LIFE – No Medicine Cures What Happiness Cannot

It’s Breast Cancer Awareness Month in case anyone’s not aware. Hwee Hwee Laurence just went for her annual gynae check last week because she’s been on tamoxifen for 5 years after chemo.

Gleefully, she writes, ‘Found uterus not normal, so now have been scheduled to go for D&C and hysterocopy – hah hah whoopie!  I feel like just taking the whole bloody thing out and get it over with.’

Atta girl ! That’s the spirit ! Cancer is not something to trivialise but it does force us to pull up and look at our life as Hwee Hwee did. I feel very blessed having friends like her, and I wish my friend mentioned in my earlier post could meet her but with the latter in Singapore and Hwee Hwee in France, we’ll have to wait for the twain to meet.

Hwee Hwee recalls :

What did I do when I discovered that I had breast cancer?  I cried.  Then I cried some more.  People will tell you – Don’t cry; it’ll do you no good.  But it will do you good.  It is only after a long crying that you will be able to blow your nose, look around you appraisingly, then ask – Now what?!  And that’s when you’ll get up and go deal with cancer in whatever way it has to be dealt with.

In a way, if cancer was to happen to anyone, I was glad it was me and not others in my family.  I help my husband in our own business and therefore have a flexible work schedule; the social security that my husband contributes to (something like the Singapore CPF except that it goes into a common pool) covers me even though I am not a French citizen.  It makes a world of a difference to be able to concentrate on getting treatment without worrying about bankrupting my family.  Each time I went for my chemotherapy session, I reminded myself that it cost a lot of money and I psyched myself up positively so that it would be half the battle won.  I am thankful for this adopted country of mine and I pray that the French people will be united and not abuse such medical privileges that they are lucky enough to have.  And I hope that, in any small way, I may be able to bring a little kindness and happiness to the people I am now living amongst.

One thing I learnt early during this period was that cancer does not exempt you from other problems of life.  After the initial diagnosis and shock, I was determined to concentrate on going through chemotherapy and getting well.  But it is naïve to think that the world waits for you while you get well.  Around you, life goes on – your husband, children or even yourself might get ill, have problems at work, school or in relationships;  there will be family members or things around the home that need your attention.  Once, in the midst of such ‘additional’ problems, I complained – this is so unfair, isn’t it enough that I have cancer? – before understanding that all this is simply life carrying on its normal way.  The opposite is true, too, that having cancer and undergoing treatment do not mean you should exempt yourself from enjoying life’s little pleasures – my children and I read and laughed together, I seduced my husband whenever I felt well enough, I went out with friends or invited them over.  Life, in its normal way, was a great reassurance during this time, not just to me, but also those close to me.

If you were to ask me what is one thing that has made this illness all worth it, I would answer without hesitation – my mother.  My mother used to worry a lot.  She had an unhappy marriage, and in a way, it made her always worry about her children’s marriages. Any small (or big) quarrel she got to know about was enough to make her worry.  She used to lament that life was better when we were kids, that even though her friends consider her lucky that her children are all grown up, married and settled down, she now has to worry for us, our husbands and our children.  It used to drive me crazy to hear such lamentations, and to wonder when she would ever learn to live life as it is and be joyful about it.

When I was diagnosed with cancer, one of the biggest stresses I had was how to tell my mother without facing another flood of lamentations which I neither have the energy nor patience to listen to.  In the end, it was my younger sister who told her and to our surprise, she took the news in good stride.  Throughout this time, my mother slowly learnt to give up her burdens and worries.  She learnt not to worry when there is nothing she can do, and what she can do, she does dedicatedly and cheerfully.  During her visit here when I was undergoing chemotherapy, she cooked up a storm, enjoyed being with the grandsons and we all had a great reunion.  There was not a single lamentation of Why so unlucky? or Why did this happen?  The only thing she said to me concerning my illness was, “Mummy is praying for you and a mother’s prayer is very powerful.”  I keep that always in my heart and it is a lesson for me to do the same for my own children.

Some months after I finished chemo and radiation therapies and having started on long-term medication, I suffered from depression, something that I had never experienced (or had much patience for, in others) before.  I saw everything in a negative light, I thought the worst of everyone and almost everything that my husband said or did irritated me.  During one brief ‘good’ moment, I thought how ironical it was that I went through so much trouble to get well only to arrive at this point where I did not care whether I live or die.  But even in the terrible depths of such feelings, I was blessed with two things.  First, my husband, despite being at the receiving end of my misplaced anger, never once retaliated but instead continued to show me kindness.  And it was this kindness that finally broke through and brought me back to normality.  And second, having been there and experienced it, I now understand better and have compassion for others who suffer from depression.

I do not know whether I will live past the next 5 or 10 years, but I do know that these last few years, strange as it might sound, have been one of the happiest periods of my life.

Dear readers, in a book by Nobel Prize Colombian writer Gabriel Garcia Marquez, there is a phrase that says, “No medicine cures what happiness cannot.”  I have that, and that is what I wish for you, too – happiness, and an abundance of it.

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LIFE – Breast friends forever

We’ve been friends since we were 8 years old. We celebrated our birthdays and took our sons to the zoo for elephant rides to give ourselves a bit of time-out. I watched her battle depression when her husband died, and just as the cloud seemed to lift, she found a lump in her breast a few months ago. The diagnosis – metaplastic sarcomatoid carcinoma (combination of metaplastic carcinoma and spindle cell carcinoma) – a particularly aggressive cancer that went from Stage 1 to Stage 3 in four months.

The lump has been removed but the cancer has not been eradicated, and while her doctors say that neither chemo nor radiation will do much good, they are still starting her on radiation in a week’s time.

Her two older children, sisters and friends are too distraught to think straight. She wants to go ahead with a party she’s planned, but they insist she should “rest”. It annoys her no end. She is already experiencing fatigue but with some planning, and the food and cleaning taken care of by a helper and her sisters, she thinks the party should go on because it might be her last.

She says she is not afraid to die. What she fears is pain and the high cost of treatment.

How do we show we care without suffocating the person? How can we help at a time like this?  Despite many friends and acquaintances being struck by various ailments from the dreaded cancer to rheumatoid arthritis, I am still a klutz at showing support. I have kicked myself black-and-blue for being insensitive eg for sounding breezy as if they will surely recover. But at the time, I thought being positive was the right attitude. Now, I’m not so sure.

At the other extreme, I just listen with no idea what to say. It might appear I don’t care when I am actually afraid I might cry.

So, I checked http://www.cancer.net/ and picked up pointers that I’m comfortable with. My own take –

  • One of the first things to hold back on is sharing well-meaning advice. It seems everyone knows some therapy or healer or fantastic supplement we can’t wait to foist on our sick friend. The intention is good, but might be unwelcome. You can mention it but take the cue from your friend. No interest? Move on.
  • Also, ring and enquire after their health, chat about general things and let them know you are thinking of them, but don’t insist on visiting if your friend doesn’t sound keen to see you. And don’t be offended.
  • Offer to run errands and rally friends around to share chores if your friend needs help. Practical assistance is more useful than just talking.

More useful advice:

Avoid saying

  • I know just how you feel.
  • You need to talk.
  • I know just what you should do.
  • I feel helpless.
  • I don’t know how you manage.
  • I’m sure you’ll be fine.
  • Don’t worry.
  • How much time do the doctors give you?
  • How long do you have?
  • Let me know what I can do. (Instead, offer specific ways you can help or other things you can provide if they need it.)

Show support with something simple like cooking and bringing over a meal for your friend (after checking dietary preferences) or accompanying him/her on a walk. It’s really the little things that make a difference.