Fasting Month 2014

'Its raining its pouring, the old man is snoring, he went to bed and bumped his head, and couldn't get up in the morning.' It finally rained after a few hot days of haze and sun. My head was throbbing so bad this morning, I predicted heavy rain. And my prediction of rain was correct. Its funny how my head hurts with the change of weather. I use to call it my barometer. 

Fasting month is a peaceful month. Muslims are commanded to fast during this period from fajar till the setting of the sun. There are so many restrictions in fasting, and breaking fast is perhaps the most joyful event of the day. It also helps bring together people as in Malaysia, the culture is to have breaking fast events where friends and family gather. With the football season on board, even sahur (meal prior to fasting) becomes a gathering, where friends and family gather to watch the world cup whilst enjoying sahur together. A lot of my patients ask me about medications you can use during fasting and I've gathered some info for the benefit of my readers.

Treatments That Are Allowed During Fasting

1. Eye drops, ear drops and ear washes as long as it doesn't pass the ear drum.

2. Sublingual GTN (Nitroglycerin) pills or other sublingual drugs that are palced under the tongue and     not swallowed to reduce angina, etc.

3. Dental works such as tooth extraction, filling, polishing as long as you do not swallow anything 

    during the procedure.

4. All forms of injections i.e. intradermal, intramuscular or IV as long as it is not nutritional.

5. Blood donation or transfer or blood taking.

6. Local application of medications in form of cream, plaster, bandage, patch etc on skin.

7. Intravascular catheter insertion for examination e.g. angiography.

8. Laparoscopic examination of the abdominal cavity via the abdominal wall.

9. Gargling water as long as it does not involve any swallowing.

10. Taking biopsy of liver or other organs for examination.

11. Dialysis treatment for kidney patients whether hemodialysis or pertoneal dialysis.

12. Local anaesthesia or partial anaesthesia with sprays or injections.

13. Usage of haemorrhoids medication to reinsert the haemorrhoids into its place without involving 

       internal cavities.

Treatments that can cancel fasting

1. Usage of inhalers for asthma or Chronic Lung diseases.

2. Using pessaries or medicine into the vagina inclusive of wash, vaginascopes, or digital 

    examination.

3. Insertion of any catheters, or urethroscope into the urinary tract, barium studies or wash for both 

    male and female.

4. Use of enemas, suppository tubes, medication protoscpe or digital examination into the anus or 

    rectum for examination.

5. Endoscopic procedures of such as ERCP, gastroscopes, etc to examine the gastrointestinal     

    system.

6. General anaesthesia.

(Source Ustaz Asmadi Mohamad Naim / Buku Panduan Pesakit JAKIM)

I hope this helps clear some of the doubts. Happy fasting peeps. :)

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For more information Call us at 014-2233268 or email to faceworksclinic@gmail.com

Farewell to Starhill ....... But its not the End

It has been a gruesome month where if some of you may have noticed, our clinic has been pretty much inactive. I have to apologise to all my patients and blog readers for the hiccup. The reason for the long silence was because we were busy moving. Yes, finally Faceworks has left Starhill.

For the initial part, I thought of taking a break from seeing patients and running a clinic. Faceworks has been my blood, sweat and tears since 2008. Being a lonely captain, it can be tough sometimes especially since the rentals were exorbitant, and the economy was flip flopping year to year. Not to mention the non-stop ongoing renovations that just seems endless.

However, despite the odds, I do have many patients and followers who have supported me all this while. So my initial thought of rest, was cut short. I have an obligation to my patients. So after the move, I started negotiating venues in order to continue my service of care for my loyal patients, to allow them the benefits that they have had before. After a few discussions, finally I've decided to join up with a senior of mine in Gleneagles Medical Office block, i.e. the private clinics.

For this month, the intended suite is still under renovations, so for appointments, I'd have to use his current suite, hence the appointment only basis is a complete must. I've retained one of my nurses Mia to help keep track of all the appointments and assist during procedures. There is so many small things to do and complete like switching phone lines etc, which would take awhile. But do not fret, our clinic mobile and gmail is still functioning - Email us and we will respond as soon as possible.

The coolest thing about moving is I get to breathe better and I get to play with Thermage. Oh yes, my senior has a Thermage that have tips expiring in this year and he has given me the permission to use and promote so that the consumables do not go to waste. So for the past week I have been doing a few Thermage cases, that actually gave not just the patient satisfaction but even my team, especially when my extended protocols for neck, and breasts are applied. I will write a full entry on Thermage in the next couple of days so that you understand what the hype is all about. If you are to curious, you can check out their official page here http://www.thermage.com/ .

So basically, all our usual services are available except for some machines since I need to arrange for them to be moved over. We are thinking to fix up my Starlux, so then I can expand my services to more interesting things. We'll see how it goes. We'll be having a mother's day event to invite patients over to introduce the new place and new services. Do email or text us if you are interested to attend. I also realised that some people are having problems accessing our website. Our website is currently on www.fwclinic.com  in view of a miscommunication with our previous web hoster. Even our store has moved to a different URL but the function is still the same http://fwclinic.com/store/.

I would like to thank all my patients, friends and followers who have been with me and supported us all this way. Without patients, I am no longer a doctor - without the patience and the care, I wouldn't be where I am now. Faceworks in Starhill is much loved, and we had so much fun there with events, parties, memories. It is sad to leave but in order to succeed we need to move on. So worry not, Faceworks may no longer be in Starhill, but we are still available, still functioning to provide to you the best aesthetic treatments with that pampering touch. Hope to see you soon.

For more information or appointments please email us at faceworksclinic@gmail.com or call us at 014-2233268.

Sweat Sweat here... sweat sweat there........

It has been a super hectic month. With Fashion Week started end of September in New York, so a lot of the boutiques were having their fall/winter collection show. Fashion is a personal interest even though I am not really a shopper. I love seeing the designs and colour themes that come out which are distinct from years before. 

The fall and winter collections are very interesting although perhaps not the best suited for Malaysia's climate. Malaysia so hot and humid, so it's almost impossible to wear tweed or fur or long coats. Besides, we do not have snow here. Its sunny year round. Because of this sort of hot humid weather..... the major problem everyone have is sweat. A quick stroll between shopping malls and you will start sweating. If the sun shines a little bit more, everyone will start sweating.

But some people sweat more than others due to hyperactive sweat glands. The term for this is hyperhidrosis. According to PubMed, "Hyperhidrosis is a medical condition in which a person sweats excessively and unpredictably. People with hyperhidrosis may sweat even when the temperature is cool or when they are at rest."

The causes can be primary or secondary to other medical illnesses. For primary hyperhidrosis, it is usually limited to a few areas of the body commonly arm pits, hands, face and back. It affects 2-4% of the world population and seem to run in families. It is a simple problem, but it can be pretty annoying to those who have it. Especially in social functions in a hot country like this, you'll be needing to bring a hanky and wear sleeveless. 

There is no permanent cure for this problem. Yes, some surgeons say you can do ETS (Endoscopic thoracic sympathectomy) but its like a double edge sword. Despite solving 85-90% of primary hyperhidrosis in palms, there is a compensatory sweating risk that occurs in 20-80% (Notice the wide range means that it is different for each individual). Not to mention the other risks which can be minimized in very careful hands but still, it is hard to say since you will be tampering with your sympathetic nerves. Plus, the procedure costs a bomb between RM 10-15K depending on center.

The over the counter aluminium chloride preparations to help inhibit sweating does work to a certain extent and is much more affordable. However, this is only for mild cases and the concentration of this compound has to be more to have a more visible effect. The common side effects would be skin irritation and later leads to darkening of the skin (note how using certain deodorants the armpit area becomes darkened?)

So the next modality of treatment that comes into my field of interest is the use of botulinum toxins (Botox/Dysport/BonTa) to help control symptoms. In the past, we learn about the use of botulinum toxins to relax muscles causing dynamic wrinkles. Then it extended to skin tightening, pore closure (yes, it can do these too if you are willing to fork out the cost) and now sweat glands. How did this came about? Well, it was observed during the early usage of BonTa on the forehead and the patient would complain of less acne or sweating. So, they studied it more and found that it does help to stop overproduction of sweat by sweat glands by making them inactive for a certain period of time. Usually, we will dilute the toxin more compared to what we use on the face as our aim is more for the sweat glands and so lower doses at a more distributed area is ideal. In fact, recently FDA of America has approved the usage for underarm sweating.

The procedure involves multiple superficial injections aiming at the subcutaneous of diluted botulinum toxin. The pain is tolerable although now with advancement of more potent pain relief, it can be minimized. It takes about an hour to complete since it involves a few things. There would be some local swelling, but usually subsides in a couple of hours. Results can be observed between 1-2 weeks after injection and lasts 4-9 months on average depending on how severe the hyperhidrosis was to begin with. Complications? Less sweating at the area of injection and dilution but for palms, there may be some muscle weakness of the palms. Cost wise - depending on the area and the technique used can be between RM 2-5K per session. Regardless, comfort is valuable and not being shy due to wet armpits and sweaty palms is makes a huge difference to your life.

For more inquires or appointments, please email to info@faceworksclinic.com or call the clinic at 03-21440080

Fasting month......

Its the fasting month and after a week of fasting, most of us have probably gotten into the cycle. The hectic afternoon jams and the sleepy mornings, make a lot of us try our best to stay indoors and not come out.

Despite so, fasting month is also a good time to get treatment done, as there are less social gatherings, and working hours are shortened. Furthermore, input from Muslim scholars have clarified on things that are not allowed to do during fasting and medical treatment has a lot of leeway. So to answer a lot of questions regarding getting things done in the fasting month, I can safely say that most everything is allowed except infusions of drips containing nutrients as that will hydrate the body. Yes, that means your fillers and botulinum toxin (bta) injections do not break your fast because most are injected either in the skin or intramuscular.

So when is the best time to get things done? For fillers and bta, I always tell my patients, at least 2 weeks before your function. Although filler results appear instantly, but the molding after 2 weeks makes it look more natural. Similarly for bta, it takes up to 3 days to start working, and at 1 week you will have the full effect and usually after 2 weeks it will soften a bit. For chemical peeling, the mild ones you can do a few days before, the deeper ones at least a week before. For Fraxel, although redness lasts about 3 days, I'd always say, reserve a week for swelling since some people react differently.

For those who are fasting, I'd recommend to drink more water at night since the skin does not heal well when dehydrated. Water as in plain water, not those sugary substances or teh tariks that will just dehydrate you more.If you tend to get dryness and skin peeling, use an extra moisturizer at night. For a healthier glow, invest in a good vitamin C serum or cream that allows good absorption. And last but not least, sunblock, sunblock, sunblock. The worst thing you can do is be out in the sun, in a dehydrated state with no sunblock - its a recipe for bad skin definitely.

For appointments do call us at 03-21440080 or email to info@faceworksclinic.com. We are open from 10am-10pm daily but for consultations, appointment required.

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For more information call us at 03-21440080 or email to info@faceworksclinic.com