One Step At A Time- #3 EatHealthy

I thought we could start with food first before the physical exercise, because basically when you choose to loose weight, you choose to modify your lifestyle and a big part to it is your food selection.

To be honest, I'm not the best person to advice on diet, but these are the things I've tried, modified a bit from our consult in Endocrine clinic & tips from my trainer:

1. Most important and difficult- CUT ADDED SUGAR. If you take coffee in the morning, take it black or with skimmed/high calcium milk. The same goes with tea.

2. Breakfast
-try overnight oats. Use rolled oats, not instant as instant has higher GI (Glycaemic Index). Make 3-5 jars on Sunday, and just grab one every morning. I top up mine with lots of different nuts plus/minus apples, oranges, banana, peanut butter, dark chocolate, honey

//Overnight oats. And yes, that's Weet-bix at the back- love it!

//For this one, I cooked the oats instead. See the chocolate pieces?

-if bread, choose wholemeal or wholegrain. If you notice, Gardenia has GI value at the back, lower is better. I love mine toasted with butter & avocado as a spread, or peanut butter/strawberry jam/cheese spread

//GI value at the back of Gardenia's bread. White bread has higher GI, opt for a lower choice

//Lately I added Laughing Cow's cheespread to couple with my avocado toast

//Let me tell you that this is incidental but it's so yummy that I'd eat this every day if golden kiwifruit isn't expensive! Above is a mix of plain yogurt, (Green Hut) granola with roasted nuts and golden kiwifruit

//Smoothiiiiieeeessss!!

-cereal-wise, I chose granola-based, add a bit of cornflakes, sometimes topped with nuts or fruits
-add on above options with an apple or banana
-also tried a bit on smoothies- Pinterest has lots and lots of recipes!
-lately been trying salad + cheery tomato + Kewpie roasted sesame dressing, sometimes with toasts too. 😋

Roughly, 1 cup of rice = 2 pieces of bread = 4 pieces of plain cream crackers (in terms of calorie)

//Yup, packed these 2 (above and below) for breakfast combi. I added nuts and granola in my salad to give that 'crunchiness'

3. Main meals
Follow the recommendation from KKM- "Suku Suku Separuh", meaning of your plate, a quarter portion is wholegrain, a quarter portion is lean protein and another half portion is fruits/greens/vegetables.

Option: change white rice to brown rice, this is what we tell our diabetic patient, mainly because of the lower GI with brown rice. Some opted to avoid rice- not saying that it's bad, but I need my rice 🤣

4. Snacking- I don't because of no time. But if you choose to- fruits or nuts. Or carrot or cucumber.
Be aware that some fruits have high sugar content like grapes and durian
Fruits that contain less sugar we adviced our diabetic patients include the green ones- guava, green apple etc

5. IF- I don't do Intermittent Fasting, simply because I need my breakfast. The bulk of my job is in the morning so I need a good breakfast to sustain me till lunch hour at least.
If you want to do it, fasting for 16 hours or more will give you more benefit so for example, last dinner at 6 pm and next meal is after 10 am
If you want to fast, I suggest do puasa Isnin-Khamis instead 👍

This is mainly notes for myself.


Next post will be a little technical, but basically, it will make you understand how I choose the exercise regime.

One Step at A Time- #2 GetFriends

//Thursday's Les Mills Tone with serra_lin@IG; a killer session every time, but worth it!

Get acquainted. Get friends. Don't do this alone. I mean, get serious friend(s) who either get into the journey with you or someone to monitor your journey.

Reasons- you need someone to keep a tab on your progress & to keep on motivating you. And trust me, you will get tired and demotivated at times.

//Easy walk at KL Tower Eco Park

//Hiking @ Tabur East

//Picnic & walk at Frim, Kepong

//Coway Run this year

If you have the means (time and financial) invest in a gym membership. Gym places usually have classes- Les Mills (under FF), HIIT-like classes, zumba, yoga etc. You can go to these classes for a starter until you find what you like, your niche- we'll talk more about this in later entries.

Invest in a personal trainer (PT) if it's within your reach/budget- because they can tailor the workout for you and they can correct your forms to avoid injuries. And because at times when you feel like you cannot go on anymore, they will push you past your limit, and you will be thankful for that.
Ask around and talk to the trainers on what they can offer.

//Burn class under Fitness First

//The fun bunch @ FF!

//Another fun bunch (quorum x complete) at the gym

My working hour isn't as flexible and I sometimes ended up finishing late- I can't keep up with some of the classes hence getting a PT was my best option. And hey, like someone said, results don't lie. [Honorary mention : khairulmuzzamir@IG]

Alternative is you can always join programme like Jom Kurus 1Malaysia or Fat Loss Challange programme by Anytime Fitness. Point is, don't walk this journey alone.

We'll talk more about workouts, exercise, and trainers in later posts.

Share with me your experience.

One Step at A Time - #1 The Trigger

This is one post that I've been delaying for months and contemplated many times simply because one, my journey isn't as great compared to others; two, I was never a sports person; and three, I wasn't and still am not sure if I could maintain this (read: istiqamah). The 'what if?' kept coming back.

But as I got more questions on how, perhaps I can share a little bit based on what I know and have practiced. I'll break the journey into different parts with different themes. So we go with first step today:

If you want to lose weight, find your reason(s) / trigger(s) to shed that kilogram and anchor it with (a) goal(s)- must be measurable, do-able and realistic.

Mine? The trigger was patient's comment while I was running the obesity clinic (something that went along the line 'but you're also not as fit to give me this advice on how to lose weight' 😑)

I had many other reasons to start losing weight- I was easily feeling tired and the timing just fit. It was around the time where I no longer need to do weekends round and someone (read: cousin Ummi) was pestering me to join the gym- more excuses to lepak with cuzzies!

So first step: Find your absolute resolution. Write down your do-able goal(s)

Mine? To get to ideal body weight, normal BMI, meaning to shed off 10kg. The aim was ~1kg per month (that's what we advice in the obesity clinic- ~1kg per month in the first 6 months)

What's yours?

#wanizsnotes

#onestepatatime

Haematology, a humbling posting

//Above is a snapshot of an abnormal blood smear magnified under the microscope

I'm doing Haematology posting. To be honest, I have always though that Haematology as a world of its own, a foreign sub-specialty even though we learnt the basic stuff in medical school. The first day of my first weekend round in Haemato, Dad sent me to the hospital and asked which posting I am in currently. When I said Haemato he went, “About blood only right? It should be easy, yes?”. I almost went berserk at that statement XD

Blood composed of a lot of constituents which include red cells, white cells, plasma, coagulation factors, platelets etc. Your white cells further have different types i.e. your granulocytes (neutrophils, basophils, eosinophils), monocytes, lymphocytes (B-lymphoctyes, T-lymphocytes, NK-cells). Each of these red and white cells as well as platelets come from a common precursor/immature cells called haemapoeitic stem cell that later differentiate into different cell lineage. Amazing yes?

During the process of differentiation and maturation, at any step the process could go wrong and thus causing your haematological cancer (leukaemia, lymphoma, multiple myeloma), and there could also be structural defects or enzymatic / constituent defects for example in red blood cells (thalassaemia, sickle cell anaemia, iron defienciency anaemia, G6PD (enzyme defiency which cause your red cells to breakdown when exposed to certain agents), haemolytic anaemia where your red cells breakdown for different reasons e.g. infection, malignancy, immune mediated where your immune system attack the red cells), or deficiency in any of the other blood products (e.g. coagulation Factor VIII or IX deficiency in haemophilia or thrombocytopenia which is low platelet which can be due to different reasons) or too much production for example in polycythaemia rubra vera where red cells production is excessive. Not only that, your bone marrow i.e. the factory that produces blood can also have problems i.e. not producing enough blood like in aplastic anaemia, myelofibrosis or abnormal production e.g. myelodysplastic syndrome. I can go on and on and on and the list will just continue.

For us, once you recognize a problem or an issue, the next step is how to manage it.

Back in medical school, our Dean Prof Hatta, taught us a prayer that I still recite until now - "O Allah the Most Merciful, the Most Benevolent, please let us be the tool of your Mercy in serving the humanity regardless of race, creed and religion"

I currently have a few patients under my care who are around my age- One gentleman with a very rare refractory extranasal, extranodal NK-T cell lymphoma whose disease is far ahead of us and kept coming faster than the next cycle of chemotherapy and he would be in pain, because the cancer “grows” on his muscles and bones. If you want to look at it from the point of “fighting cancer”, we’re definitely at the loosing end. Patient and family however is still looking for a miraculous cure.

Another gentleman with progressive lymphoma, now affecting his central nervous system which made me learn about Omaya Shunt and intraventricular chemotherapy. His condition is complicated with many infections after infections which affect his chemotherapy schedule. He asked “why did I get (all) these (infections), Dr?” My reply, because he's immunocompromised, meaning his immune system is low hence he could easily catch any sort of infection. But beneath that question is, "Why me?"

Haematology for me is a very humbling posting- from dealing and learning from these patients, to learning from my consultants and specialists; amazed at the level of passion and care they have for their patients, and it made me realized again and again that the more I learn, the more I don't know...

"Which then of the bounties (favours, gifts) of your Lord will you deny?" 
[ar-Rahman 55:13]