Sri Mersing's little steps and giant leaps on the web
Thursday, August 27, 2009
Saturday, August 22, 2009
Ayman's 8 month milestone
Yes... the following are some skills that my 8 month old son has mastered. Again he has all the three skills combination- mastered skills/emerging skills/advanced skills.
Hmm I wonder whether he'll walk before 1 year old?
Mastered Skills (most kids can do)
• Says "mama" and "dada" to both parents (isn't specific) - we didn't teach dada .. only mama.
• Passes objects from hand to hand - yep he did this
Emerging Skills (half of kids can do)
• Stands while holding onto something - he did this when he was 7 month old .. and now he is more stable .. sometimes he let go of his hand .. lepas tu jatuh le.
• Crawls - mastered since he was 5 months
• Points at objects - mmmm i don't see him point .. i see him crawling and grabbing the things that he is interested in .. especially the aircond remote control.. sanggup menjerit le kalau kita sorok bawah meja.
• Searches for hidden objects - yep he did it today.
Advanced Skills (a few kids can do)
• Pulls self to standing, cruises - yep did he did stand .. memula he kneels .. then cari support .. wall ke meja ke .. mak dia ke .. lepaih tu dia mula bongkok kan badan .. pastu berdiri .. lepaih tu mula la nak capai hujung meja nak pi sana pula .. but i normally support him as he would fall if he let go of his hands or if his knees buckle up!
• Picks things up with thumb-finger pincer grasp - yep .. did that
• Indicates wants with gestures - of course!!!
Hmm I wonder whether he'll walk before 1 year old?
Mastered Skills (most kids can do)
• Says "mama" and "dada" to both parents (isn't specific) - we didn't teach dada .. only mama.
• Passes objects from hand to hand - yep he did this
Emerging Skills (half of kids can do)
• Stands while holding onto something - he did this when he was 7 month old .. and now he is more stable .. sometimes he let go of his hand .. lepas tu jatuh le.
• Crawls - mastered since he was 5 months
• Points at objects - mmmm i don't see him point .. i see him crawling and grabbing the things that he is interested in .. especially the aircond remote control.. sanggup menjerit le kalau kita sorok bawah meja.
• Searches for hidden objects - yep he did it today.
Advanced Skills (a few kids can do)
• Pulls self to standing, cruises - yep did he did stand .. memula he kneels .. then cari support .. wall ke meja ke .. mak dia ke .. lepaih tu dia mula bongkok kan badan .. pastu berdiri .. lepaih tu mula la nak capai hujung meja nak pi sana pula .. but i normally support him as he would fall if he let go of his hands or if his knees buckle up!
• Picks things up with thumb-finger pincer grasp - yep .. did that
• Indicates wants with gestures - of course!!!
Flu .. Flu and more Flu
Okay .. the whole house is down with flu. I'm not sure whether its common flu or viral flu...Anyways, I had enough of flu already la.. this would be my third week having flu. I've changed antibiotics 3 times .. had dozens of pills shoved into my throat but the flu is stil there. NOTE : I don't have fever .. I have runny nose for the last 3 weeks .. and cough! So I don't think I have the H1N1 thingy... getting paranoid really .. its H1N1 is spreading like hell here in Malaysia. Read the news people! Atleast no death yet for today!
Do you know how much money I wasted on medicines for the three of us?? Myself, Naureen and Ayman????!!! Nearly 1000MYR for August 2009 and its all due to the flu bug!
Dengan GP di Setiawangsa adalah ulang alik 5 kali (utk 3 orang) so congak congak .. around RM 300++ sebab doc cakap dia bagi Antibiotic yg mahal. Naureen improve lah .. tp dia masih ada batuk batuk sampai sekarang. Ayman worst case scenario .. pergi third time to GP .. he said no improvement .. go to hospital .. he wrote a referral letter. So on Tuesday (18/8/2009) I went straight to Ampang Puteri Specialist. Thats where they were born and their Paediatrician is also there. Bill charged?? RM 370++.. itu pun i told Doc .. I don't want my son to be warded! If warded .. damn kena fork out another 1K ++ daaa. Thank God for Insurances!!! So I took 1 week leave and travelled three times a day to the A&E for my son's neb. Next week on Tuesday, I have to go back to Doc Nasir and I hope AYman's health would improve. Doc said if phlegm not reducing .. warded! Me?? what about me.. yesterday evening I have probs breathing .. feel that my chest was becoming heavy.. I was having shortness of breath during the ICT Council meeting??? Today I went to see my specialist cum relatives .. Dr Mat Ripin.. huh kena lagi bil RM 270++ .. He perscribed .. seretide .. vantolin (semua ni ubat asthma!).. flu and FLUMOCIL A600 for my phlegm .. minggu depan Hari Jumaat jumpa lagi dia.
Ni nak cerita perbualan dgn Dr XXXXX lah ni pagi tadi :
I told him I was afraid if I had H1N1 or Influenza like illness as mentioned in the papers. I was wearing a mask while talking to him. The moment I said that I was having flu.. he took a step back and wore his mask *chuckle*. I explained that I don't have fever but it all started with a sore throat.. runny nose and cough. He checked my lung was clear.. all is good so he simply said if you had H1N1 .. it has come and gone ... as its already been 3 weeks. In my mind ... i was saying to myself .. ha ah ek .. kalau aku dapat H1N1 .. aku dah mati gamaknya .. sebab aku tanggung merana dgn flu ni dah 3 minggu .. sampai kepala aku naik sengal and sakit. Lepas tu told him that XXXXX byk kes Influenza like illness .. ramai student pergi clinic.. terus Dr cakap .. student U mmg ada yang dah kena H1N1. Ada warded di sini.. still here. He told me an alarming figure .. out of 10 samples they sent out for testing .. normally 8 come out positive. Tak gila ka tu? meaning its a lot.
So I have two small children.. I am working in an environment that is prone to H1N1. I am working in an international university where there is already a confirmed H1N1 case. So I have to take precautionary measures lah..
I am taking out Naureen out of kindergarden as of now ... it worries me. really .. worries me.
So as you can see .. August is the month of nightmare for me .. financially, emotionally drained and physically lembek?! boleh????
Do you know how much money I wasted on medicines for the three of us?? Myself, Naureen and Ayman????!!! Nearly 1000MYR for August 2009 and its all due to the flu bug!
Dengan GP di Setiawangsa adalah ulang alik 5 kali (utk 3 orang) so congak congak .. around RM 300++ sebab doc cakap dia bagi Antibiotic yg mahal. Naureen improve lah .. tp dia masih ada batuk batuk sampai sekarang. Ayman worst case scenario .. pergi third time to GP .. he said no improvement .. go to hospital .. he wrote a referral letter. So on Tuesday (18/8/2009) I went straight to Ampang Puteri Specialist. Thats where they were born and their Paediatrician is also there. Bill charged?? RM 370++.. itu pun i told Doc .. I don't want my son to be warded! If warded .. damn kena fork out another 1K ++ daaa. Thank God for Insurances!!! So I took 1 week leave and travelled three times a day to the A&E for my son's neb. Next week on Tuesday, I have to go back to Doc Nasir and I hope AYman's health would improve. Doc said if phlegm not reducing .. warded! Me?? what about me.. yesterday evening I have probs breathing .. feel that my chest was becoming heavy.. I was having shortness of breath during the ICT Council meeting??? Today I went to see my specialist cum relatives .. Dr Mat Ripin.. huh kena lagi bil RM 270++ .. He perscribed .. seretide .. vantolin (semua ni ubat asthma!).. flu and FLUMOCIL A600 for my phlegm .. minggu depan Hari Jumaat jumpa lagi dia.
Ni nak cerita perbualan dgn Dr XXXXX lah ni pagi tadi :
I told him I was afraid if I had H1N1 or Influenza like illness as mentioned in the papers. I was wearing a mask while talking to him. The moment I said that I was having flu.. he took a step back and wore his mask *chuckle*. I explained that I don't have fever but it all started with a sore throat.. runny nose and cough. He checked my lung was clear.. all is good so he simply said if you had H1N1 .. it has come and gone ... as its already been 3 weeks. In my mind ... i was saying to myself .. ha ah ek .. kalau aku dapat H1N1 .. aku dah mati gamaknya .. sebab aku tanggung merana dgn flu ni dah 3 minggu .. sampai kepala aku naik sengal and sakit. Lepas tu told him that XXXXX byk kes Influenza like illness .. ramai student pergi clinic.. terus Dr cakap .. student U mmg ada yang dah kena H1N1. Ada warded di sini.. still here. He told me an alarming figure .. out of 10 samples they sent out for testing .. normally 8 come out positive. Tak gila ka tu? meaning its a lot.
So I have two small children.. I am working in an environment that is prone to H1N1. I am working in an international university where there is already a confirmed H1N1 case. So I have to take precautionary measures lah..
I am taking out Naureen out of kindergarden as of now ... it worries me. really .. worries me.
So as you can see .. August is the month of nightmare for me .. financially, emotionally drained and physically lembek?! boleh????
Friday, August 14, 2009
An interesting article read on 13/8/2009 on Influenza A H1N1
Don’t withhold anti-virals- from The Star
THE current situation with regard to A(HINI) has compelled me to write this letter. The A (HINI) flu is a viral disease that is amenable to treatment if anti-virals are administered early. However, I feel that the recommendations for treatment by the Health Ministry are too tight.
A number of households within the past two weeks, especially those that are in contact with the public such as medical personnel, students and teachers, have had members of the family down with flu.
Any flu-like illness, especially among those already vaccinated with flu vaccine, within the last two weeks is most probably HINI unless proven otherwise.
The disease has become too widespread to be contained, and steps taken to prevent the spread may prove ineffective. Hence, the next option is to deal with the situation in the most appropriate manner. And that is to administer treatment to the appropriate group early.
Those who get the infection will become immune, and when enough of the population has acquired the infection and become immune, then we get herd immunity and the disease can be contained.
Looking at the symptoms, they are fairly consistent. Most of them start with sore throat and dry cough associated with fatigue and cold intolerance for a few days followed by cyclical fever which usually occurs in the evening. Watery runny nose occurs about one day after the onset of fever and is usually transient unless there is a secondary bacterial infection.
Some patients may have diarrhoea at this stage. Some have milder disease with low grade fever. Note that there is no bone or joint pain or severe headache as opposed to dengue, and that in dengue, there is usually no symptoms of runny nose.
While a nasal swab is helpful with the diagnosis, it has a high false negative rate, hence patients may be wrongly diagnosed. Therefore, clinical judgement is more important.
As we are all aware, the disease does not only cause fatality among the immuno-suppresed, but also healthy individuals, and if we follow closely, we will see that some of those who died had received outpatient treatment for flu prior to their death.
The current recommendation for treatment with anti-virals (http://h1n1.moh.gov.my/caseManagement.php) is too rigid and may be too late because the anti-viral is most effective if given within 48 hours of the onset of symptoms. Often, those who came early for treatment with flu-like illnesses were sent home with antibiotics which gave a false sense of security not only to the patient but also to the doctor.
According to the Health Ministry’s recommendations, if patients have no risk factor, they have to become moderately ill before they can be admitted and receive treatment with anti-virals. By that time it may be too late or the anti-viral may not be as effective or they may already be dead!
A few fatal cases were in fact relatively well at presentation but deteriorated very fast. Within hours the patient succumbed to the illness.
Patients who have high grade fever and are unwell for more than one day associated with flu-like illness should be given the option of receiving treatment with anti-virals.
The British Medical Journal research is correct to say that many people with swine flu only get mild symptoms, and they may find bed rest and over-the-counter flu remedies work for them.
“But for those who experience severe symptoms, the best scientific advice tells us that anti-virals should still be taken as soon as possible — and to suggest otherwise is potentially dangerous”.
No doubt, there are concerns about side effects and resistance to anti-virals, but at this point in time, it is not justified whatsoever to let them run the risk of fatal complications since more than 10% of mortality were from among previously healthy individuals. I repeat, the mistake is withholding anti-viral treatment for patients who deserve it. We have to be less stringent in our criteria to treat.
DR SAADIAH SULAIMAN,
Dermatologist,
Hospital Pakar Annur, Bangi.
-----
N.B : I am going to Klinik Mesra again to check on my flu and cough. I have finished one round of antibiotics but i am still having block nose .. cough. Right now I am breathing through my mouth. Both my nostrils are blocked!
THE current situation with regard to A(HINI) has compelled me to write this letter. The A (HINI) flu is a viral disease that is amenable to treatment if anti-virals are administered early. However, I feel that the recommendations for treatment by the Health Ministry are too tight.
A number of households within the past two weeks, especially those that are in contact with the public such as medical personnel, students and teachers, have had members of the family down with flu.
Any flu-like illness, especially among those already vaccinated with flu vaccine, within the last two weeks is most probably HINI unless proven otherwise.
The disease has become too widespread to be contained, and steps taken to prevent the spread may prove ineffective. Hence, the next option is to deal with the situation in the most appropriate manner. And that is to administer treatment to the appropriate group early.
Those who get the infection will become immune, and when enough of the population has acquired the infection and become immune, then we get herd immunity and the disease can be contained.
Looking at the symptoms, they are fairly consistent. Most of them start with sore throat and dry cough associated with fatigue and cold intolerance for a few days followed by cyclical fever which usually occurs in the evening. Watery runny nose occurs about one day after the onset of fever and is usually transient unless there is a secondary bacterial infection.
Some patients may have diarrhoea at this stage. Some have milder disease with low grade fever. Note that there is no bone or joint pain or severe headache as opposed to dengue, and that in dengue, there is usually no symptoms of runny nose.
While a nasal swab is helpful with the diagnosis, it has a high false negative rate, hence patients may be wrongly diagnosed. Therefore, clinical judgement is more important.
As we are all aware, the disease does not only cause fatality among the immuno-suppresed, but also healthy individuals, and if we follow closely, we will see that some of those who died had received outpatient treatment for flu prior to their death.
The current recommendation for treatment with anti-virals (http://h1n1.moh.gov.my/caseManagement.php) is too rigid and may be too late because the anti-viral is most effective if given within 48 hours of the onset of symptoms. Often, those who came early for treatment with flu-like illnesses were sent home with antibiotics which gave a false sense of security not only to the patient but also to the doctor.
According to the Health Ministry’s recommendations, if patients have no risk factor, they have to become moderately ill before they can be admitted and receive treatment with anti-virals. By that time it may be too late or the anti-viral may not be as effective or they may already be dead!
A few fatal cases were in fact relatively well at presentation but deteriorated very fast. Within hours the patient succumbed to the illness.
Patients who have high grade fever and are unwell for more than one day associated with flu-like illness should be given the option of receiving treatment with anti-virals.
The British Medical Journal research is correct to say that many people with swine flu only get mild symptoms, and they may find bed rest and over-the-counter flu remedies work for them.
“But for those who experience severe symptoms, the best scientific advice tells us that anti-virals should still be taken as soon as possible — and to suggest otherwise is potentially dangerous”.
No doubt, there are concerns about side effects and resistance to anti-virals, but at this point in time, it is not justified whatsoever to let them run the risk of fatal complications since more than 10% of mortality were from among previously healthy individuals. I repeat, the mistake is withholding anti-viral treatment for patients who deserve it. We have to be less stringent in our criteria to treat.
DR SAADIAH SULAIMAN,
Dermatologist,
Hospital Pakar Annur, Bangi.
-----
N.B : I am going to Klinik Mesra again to check on my flu and cough. I have finished one round of antibiotics but i am still having block nose .. cough. Right now I am breathing through my mouth. Both my nostrils are blocked!
Wednesday, August 5, 2009
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