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How to get the most out of your consultation

How to get the most out of your consultation

Written by Dr. Haroon Thowfeek

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Before your consultation on oDoc, it is best to be well prepared. A well-organized patient not only makes efficient use of the doctor’s time but is also likely to get better medical care, as they are helping the doctor a great deal in making an accurate diagnosis. Here are the steps you can take:

  • Create a list of issues or queries you want to discuss
  • Makes sure you have all your medical records with you. You may even bring a note book to jot down all the important information the doctor tells you.
  • Remember to inform your doctor about all your symptoms. List them in a chronological order, starting from the time when you first noted that something was not right
  • Make a list of all the medications you are taking or let your doctor know what remedies you have tried earlier, and whether they have helped you or not. Alternatively, you can collect all your medicines and show them to your doctor.
  • If you have consulted a doctor earlier or have undergone relevant tests, please share this information with your present doctor. This information will help your doctor plan your treatment better.

Once you’ve spoken about the above with your doctor, you can ask him what he thinks your condition could be. If you do not agree with the doctor’s diagnosis, make sure to ask them more questions and understand why the doctor has come to this diagnosis. If you do not agree with it, you are unlikely to follow his advice and treatment, so it is always best to get your concerns sorted.

When the doctor presents you with a diagnosis, you can ask the following questions:

  • What is the diagnosis? Find out the complete medical name – and what it means in plain Sinhala/Tamil/English!
  • What is my prognosis (outlook for the future)?
  • What changes, if any, will I need to make in my daily life?
  • Is there a chance that someone else in my family might get the same condition?

If you cannot understand your doctor’s explanations, here are a few questions you can ask:

  • Could you explain in simple Sinhala/Tamil/English?
  • Can you write it down for me?
  • Can you draw what you are describing?
  • Where can I find more information about this subject?

What happens if you and your doctor differ about a treatment option? Let me point out that there’s a right way of approaching your doctor and a wrong way. It’s simply a matter of mutual respect; you wouldn’t want your doctor to assume the worst about you, so, don’t assume the worst about him! Often, if you can put across your feelings and apprehensions in the right way, you can get your doctor to help you. Explain your needs to the physician in a polite way, without any belligerence or hostility. Remember that you are both on the same side – yours!

In order to best support your doctor and them you, make sure to do the following:

  • Get ready for your appointment on time or if you are unable to make the appointment, cancel ahead of time  
  • Do your best to explain exactly what is bothering you. i.e. You can express your anxieties and apprehensions clearly.
  • Answer the doctor’s questions honestly.
  • Volunteer any important information that the doctor may not specifically ask about, including family history.
  • Let the doctor know if you cannot follow his directions and specify the reasons why.
  • Take medications as directed, strictly adhering to the dose schedule. Do not stop taking your medication once you feel better. Make sure to stick to the timelines your doctor has provided you with.
  • If you disagree with your doctor, express your  dissatisfaction in a courteous manner

While your doctor can provide guidance on your sicknesses or any medical conditions, you will be doing most of the legwork in getting your mind and body to its healthiest state.  So take an active interest in your medical care. After all, this is the only body you have! Patients who know how to make the most of their doctor get better medical care. Therefore, it’s very important that you learn how to do so!

How to get the most out of your consultation - Dr. Haroon Thowfeek

Dr. Haroon Thowfeek, MD

Family Physician on oDoc

SLMC Number 35006

Sri Jayewardenepura General Hospital

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Blog Article Women's Health

All you need to know about Gestational Diabetes

All you need to know about Gestational Diabetes

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Did you know that gestational diabetes mellitus, also known as GMD, is one of the most common medical complications of pregnancy?

What is GMD? Why does it happen? Can you prevent it? Keep scrolling for answers.

So, let’s start with the basics. What is gestational diabetes?

Gestational diabetes is high blood sugar that develops during pregnancy and usually disappears after giving birth. Many hormones are involved in maintaining the blood sugar level. As the hormone levels fluctuate during pregnancy, they prevent the body from using insulin effectively, leading to insulin resistance. This causes  glucose  build-up in the blood instead of being absorbed by the cells. Typically, the pancreas can make additional insulin to overcome insulin resistance, but when insulin production is not enough to overcome the effect of the placental hormones, gestational diabetes results.

A study conducted by Kai Wei Lee et., found the prevalence of GDM in Asia was 11.5%. GMD can happen at any stage of pregnancy but is more common in the second or third trimester.

But why is that?

Scientists have not been able to identify the exact hormone that causes GDM in pregnant women. But, many scientific theories suggest that as the placenta grows, more and more hormones are released, which increases risk of  insulin resistance. Thus, symptoms of GMD are seen more often in the 2nd and 3rd trimesters. 

What are the symptoms of GMD?

Many women who have GMD do not show symptoms, but the most common ones are: 

  • Increased thirst
  • Urgency to pee more often
  • Dry mouth
  • Tiredness
Gestational Diabetes Causes

These symptoms are relatively common during pregnancy and not necessarily a sign of GMD. If you are pregnant and have noticed these symptoms, you should speak to a VOG doctor or a general physician, via oDoc who will provide a prescription for a lab test. You can carry out the lab tests from the comfort of you home via oLabs too. 

Who is at risk?

GMD can affect any woman, but a list of risk factors identified by scientists increases the chances of developing GMD. 

The risk factors include

  • Being overweight before pregnancy
  • Having a family  history of diabetes 
  • Being Prediabetic (if you have a blood glucose level higher than normal but not high enough to be classed as diabetic.
  • Having PCOS 
  • Being older than 25 as they are at a greater risk for developing gestational diabetes than younger women
  • Having high blood pressure, high cholesterol, heart disease, or other medical complications
  • Having  given birth to a large baby (weighing more than 9 pounds)
  • Having had a miscarriage

How does GMD affect the mother and the baby?

More often than not, women who have GMD go on to have normal pregnancies and deliver healthy babies. However, in other circumstances, GMD can lead to:

  • Macrosomia. This is where the baby grows very large as they absorb the excess glucose in the mother’s blood and convert it into fat and are deposited. This leads to difficulties during labour, causing doctors to opt for induced labour and c-section. 
  • Too much amniotic fluid (the fluid that surrounds the baby) in the womb can cause premature labour or problems at delivery, known as polyhydramnios.
  • Premature birth
  • Low blood sugar (hypoglycemia) in the baby after delivery. This happens because the mum’s high blood sugar level also causes the baby to have a high blood sugar level, and after birth, it no longer has the high level of sugar from its mother, resulting in the newborn’s blood sugar level becoming very low.
  • Obesity and type 2 diabetes later in life for babies. Babies of mothers with gestational diabetes have a higher risk of developing obesity and type 2 diabetes later in life.
  • Stillbirth. Untreated, gestational diabetes can result in a baby’s death before or shortly after birth.
  • Future diabetes for the mother. If you have gestational diabetes, you’re more likely to get it again during a future pregnancy. You also have a higher risk of type 2 diabetes as you get older.

What are the treatment options?

The American Diabetes Association recommends screening for undiagnosed type 2 diabetes at the first prenatal visit in women with diabetes risk factors. In pregnant women not known to have diabetes, GDM testing should be performed at 24 to 28 weeks of gestation. 

If you are found to have GMD, don’t worry, as it can be treated, and complications can be reduced. The doctor may ask you to monitor your blood sugar level often, exercise often, eat healthily and maybe give insulin injections if necessary. 

How is it prevented?

There are no guarantees for preventing gestational diabetes — but the more healthy habits you can adopt before pregnancy, the better.

So don’t forget to 

  • Eat healthy – Choose foods high in fibre and low in fat and calories.
  • Exercise often – Exercising before and safely during pregnancy can help protect you from developing gestational diabetes.
  • Start pregnancy at a healthy weight. If you’re planning to get pregnant, losing extra weight beforehand may help you have a healthier pregnancy.
Preventing Gestational Diabetes

If you are pregnant and experiencing any of the symptoms mentioned above or have any questions, you can speak to one of the Obstetricians, Gynaecologists or GPs on the oDoc app. Click here to download the app.

Sources 

  1. Alfadhli, E., 2015. Gestational diabetes mellitus. Saudi Medical Journal, 36(4), pp.399-406.
  2. Gestational Diabetes Mellitus (GDM). (n.d.). Johns Hopkins Medicine. Retrieved April 6, 2022, from 
  3. Gestational diabetes – Symptoms and causes. (2020, August 26). Mayo Clinic. 
  4. NHS website. (2021, November 29). Gestational diabetes. Nhs.Uk. 
  5. Lee, K.W., Ching, S.M., Ramachandran, V. et al. Prevalence and risk factors of gestational diabetes mellitus in Asia: a systematic review and meta-analysis. BMC Pregnancy Childbirth 18, 494 (2018).
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Endometriosis

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Endometriosis

Endometriosis

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No woman looks forward to “that time of the month.” Dealing with nausea, stomach cramps, mood swings, back pains and fatigue, all whilst facing that undeniable social pressure of pretending to be ‘normal’ and going about your daily activities. Because periods are a natural bodily function… right? It’s not like a cold where you would be rightfully exempted from resuming your daily tasks.

Sadly, sometimes the society we live in doesn’t accurately weigh the impact of periods on our daily functioning. A good example of this is one of the most common gynecological diseases, endometriosis, often going undetected for years because the abdominal pain it causes is dismissed as regular menstrual cramps. Endometriosis is typically a progressive condition. Therefore it’s wise to look out for signs early on and get regular checkups with your VOG to manage any symptoms you have. You can easily channel a VOG in just three taps on oDoc!

What is endometriosis?

The lining of your uterus is made up of tissue called the endometrium. When this tissue grows outside your uterus, it’s known as endometriosis. This disorder causes endometrial-like tissue to grow on your ovaries, fallopian tubes, bowel, and even tissues lining your pelvis.

Unfortunately, this endometrial-like tissue acts as endometrial tissue would — meaning that according to the hormonal changes in each stage of the menstrual cycle, it thickens, breaks down and bleeds. But because it has no way to exit your body, it becomes trapped! This triggers an inflammatory response, and the surrounding tissue becomes irritated, eventually developing scar tissue and adhesions, which are bands of fibrous tissue that can cause pelvic tissues and organs to stick to each other. This leads to pain and other complications discussed below.

Symptoms of endometriosis

Just like all the chocolates we eat on our period are unique in their own way, the endometriosis symptoms experienced by you may differ from that of someone else. Some people experience mild symptoms, but others can have moderate to severe symptoms. The severity of pain you feel doesn’t indicate the stage of the endometriosis you have. You can have a mild degree of endometriosis, but experience agonizing pain or have a severe form of it and have minimal discomfort. That is why it’s important for you to get regular gynecological exams to stay on top of your reproductive and sexual health!

Pelvic pain is the most common symptom of endometriosis. You may also have the following symptoms:

  1. Painful periods – Most women have period cramps, but endometriosis can leave you with debilitating pain. You can get cramps 1 or 2 weeks around menstruation
  2. Heavy menstrual bleeding or bleeding between periods
  1. Painful intercourse – Women might have intense, localized pain during penetration
  2. Infertility – When endometriosis affects the ovaries or fallopian tubes, it may reduce the eggs’ chance of becoming fertilized and implanting into the uterus lining
  1. Painful bowel movements and/or urination
  2. Pain in the abdomen, lower back, or thighs, often lasting throughout the cycle

It’s wise that you get regular gynecological exams, which will allow your VOG to monitor any changes. This is particularly important if you have two or more symptoms.

Endometriosis Treatment

Until endometriosis is better understood, only the symptoms can be treated without the underlying causes. Endometriosis treatment depends on your symptoms and goals.

For example, suppose your goal is to minimize the pain. In that case, you may be prescribed over-the-counter pain medications such as Ibuprofen or hormonal medicines such as the oral contraceptive pill, which can suppress the period and stop mild to moderate endometriosis from progressing. It decreases fertility by preventing the monthly growth and buildup of endometrial-like tissue, reducing the pain.

Other options are available if you wish to conceive, such as undergoing a laparoscopy. In this minimally invasive surgery, your doctor will make small incisions in the abdomen to explore and surgically remove any problematic tissue without damaging your reproductive organs. Even though the name of this surgery sounds scary, most women can go home on the same day as the operation, and it will take roughly five to seven days to recover.

However, if you don’t respond to conservative treatments, your doctor may recommend a total hysterectomy as a last resort. In this operation, your surgeon removes the uterus, fallopian tubes and in some cases, even the ovaries, depending on the severity of the disease.

Life with endometriosis

Living with endometriosis can be difficult as symptoms can significantly impact your quality of life. It may take a toll on your mental health as finding an effective treatment and dealing with the anxiety of symptoms flaring up can be emotionally taxing. It may even cause financial strain depending on the cost of your treatment plan or if your symptoms interfere with your ability to maintain a job. It may also lead to an unfulfilled sex life which may cause a bridge between you and your partner.

To improve your quality of life with endometriosis, it’s good to reduce stress by regularly partaking in leisure activities, exercising and getting adequate sleep. While endometriosis can be isolating, remember that you’re not alone. There are many ways to find support, like joining an online or in-person support group and talking to a mental health professional to work through your feelings. You can easily channel a mental health professional in simply three taps on oDoc!

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Annoying toddler’s habits that are actually good for them

Annoying toddler’s habits that are actually good for them

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“Again, Ma, read it again!” for the 100th time is not the most satisfying thing to hear as new parents. Loving your children doesn’t mean they won’t irritate you. Toddlerhood is when your child develops emotionally, cognitively, and socially, making them curious and eager to explore and test boundaries. This could be chaotic but, coming to think of it, even rewarding at times.

Even though your toddlers may sometimes drive you a little crazy, these 5 behaviours are actually crucial to your child’s learning and emotional development. 

1. Request the same book, song or show over and over again

You might have read the same book, sung the same song or played the same show about 100 times now and would feel exhausted. But, here’s what you need to know.

  • Hearing the same words repeatedly helps with language development.

Yes, there are fewer words and minimal variety, but your kids often engage with what they hear, and they hear it often. This helps them to process those words and remember them effectively.

  • It helps them to feel in control throughout the day.

The routine of reading the same book repeatedly can help your children have a little structure in a world full of surprises new experiences, and seem crazy to them.

  • Contributes to a peaceful sleep 

Prioritise your child’s bedtime stories as part of a bedtime ritual to help them settle, to help them reach a calm state, allowing them to fall asleep easily.

Parent dealing with annoying toddler habits
2. Make a huge mess

To clean all day and night might be your worst nightmare, and everything your little one gets a hold of might end up being a mess. It might be tough to embrace the mess as parents, but here’s what you need to know.

  • Messy play encourages your children to develop gross and fine motor skills and coordination and concentration skills. 

This helps your toddler take risks, negotiate, solve problems, be creative and discover new things. Hence, remember the mess might irritate you, but your little one’s brain is growing too,

  • It helps your toddler gain confidence.

Messy play is not about creating a finished object, so children who lack confidence or are scared of failure would not hesitate to try out new things and be innovative with what they’re around, which would help build their confidence and improve their focus.

  • Improves their problem-solving skills

You can use this opportunity to teach your child the importance of responsibility. Your little ones may not always live upto your standards but involving them while cleaning up the mess, putting their toys back into the box and arranging the mess might help them with problem-solving skills as it consists of thinking and intelligent work.

3. Tantrum

Tantrums are one of the most challenging aspects of parenting. No matter how good and bubbly you try to be around your little one, tantrums are hard to avoid. You may feel helpless and overwhelmed but believe it or not, these tantrums are an essential part of your toddler’s emotional health and well-being.

  • Better out than in

When we cry, we release stress from our body (our tears contains cortisol – stress hormones). So does your toddler. You may notice pre-tantrum signs such as anger, frustration, or whining and post-tantrum signs such as calmness and an overall better mood. The world is big, crazy, and very new from their point of view, so they become emotional when their thoughts are blocked, or things don’t work their way. This results in tantrums which will help them get over that discomfort eventually. 

Annoying things toddlers do you should know as a parent
  • Better sleep

Most parents believe it’s better to put them to sleep than deal with tantrums. However, just like adults, children also wake up because they’re stressed or trying to process something happening in their lives. Hence, allowing your child to get to the end of the tantrum improves emotional well-being and may result in better sleep through the night.

  • Your child will feel safe to tell you how they feel.

Most often, children don’t use tantrums to manipulate or get what they want. When their toy is broken or their building blocks aren’t cooperation with them, all they need is some love and comfort. However, even if they were wrong, you can stand firm with a ‘no’ and still emphasise with them.

However, toddlers are able to learn how to express their feelings and they just need to be guided in the right direction. When children don’t accurately describe how they are feeling, you may have a much harder time knowing how to help them. Hence, it is important to label your children’s feelings for them, help them notice other people’s feelings and watch shows and read books where feelings are highlighed. Until your child goes to school, you will have to help them create their vocabulary.

Active toddler bouncing around
4. Bounce around and refuse to sit still

It may be hard to handle a wiggly worm all the time and asking your toddler to sit still maybe part and parcel of parenting. However, here’s what you need to know.

Movement stimulates your toddler’s brains and it releases chemicals that contribute towards focus, memory, motivation and mood. In other words, the fundamental in the art of learning.

5. Cling to you for dear life

A clingy toddler can be irritating while chatting with friends when going out or dropping them off at nursery for the first time. 

  • Hugging could make your toddler smarter

A newborn learns to navigate through physical contact such as skin-on-skin contact and hugs. Touch is the first to develop out of our five senses so nurturing touch provides the stimulation young brains need for normal growth and development.  

  • Hugging can stop tantrums

Just like adults, even children lose control of their emotions and when your toddler has an emotional tantrum, their motive is never to ruin your day. They’re only releasing emotions in response to something in their environment.

parent holding on to clingy child

Hugging your toddler at these times of intense emotional outbursts will help calm them down and help them realise that you are there to support them during hard times.

Toddlers can sometimes drive you crazy and drain all the energy you have. But most of what your child is doing on a daily basis helps explore the love of learning, innovating and creating. Let your child be the next great explorer and encourage this love for life and its wonders as much as you can. If you have any questions regarding your toddler’s health or would like some medical advice, you can consult a paediatrician or a general physician from the comfort of your home via the oDoc app. Click here to download oDoc now.

“As your kids grow, they may forget what you said, but won’t forget how you made them feel”.
-Kevin Heath-

Reference
  1. 7 Annoying Things Toddlers Do That Are Actually Good for Them, Pick Any Two (2020)
  2. Why making a mess can be beneficial for children, Good start early learning (2017)
  3. 10 Reasons Your Toddler’s Tantrum Is Actually a Good Thing, Parents (2021)
  4. A Step by Step Guide to Help Toddlers Express Their Feelings, AT Parenting survival (2022)
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How To Manage Stress

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Blog Article Mental Health

How To Manage Stress

How To Manage Stress

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With the cost of living rising rapidly by the day, the currency devaluing, and the country falling into economic decline, it is no surprise that STRESS LEVELS ARE AT AN ALL-TIME HIGH. I just grew 10 additional grey hairs typing this sentence.

So many of these factors are mostly out of your control. But there are many actions you can take to relieve your stress and approach difficult situations differently.

Be active 

Running on the treadmill won’t make your stress completely disappear. But staying active with daily exercise can relieve some of the emotional intensity you’re feeling. This helps clear your mind and lets you face issues more calmly. Exercise is shown to release endorphins – natural chemicals in your body that help you feel better and more positive.

exercise

 

Eat and drink healthily

Alcohol and binge-eating doesn’t make your stress vanish. They can help in the moment but can actually add to your stress in the long run. You’ve heard it before but you’ll hear it again. Consuming a healthy, balanced diet can alleviate some of the stress you’re feeling.

 

Identify stress triggers for yourself

Sometimes, the causes of stress are within your control. Maybe you are not able to manage your time well between work and family or maybe you have an upcoming deadline. You can improve your time management skills by asking for help either from your loved ones or a licensed professional, setting priorities and pacing yourself.

causes of stress
stress management

 

Connect with your loved ones

Having a supportive community of family, friends and colleagues can help ease your troubles and even get you to think about a problem in a different way. Having a laugh, doing a fun activity, gossiping over a meal are all excellent stress relievers!

 

Say ‘’No’’

With that being said, it’s okay to say ‘’No.’’ Sometimes saying ‘’yes’’ to everything that is demanded of you can burn out your time and energy. Setting those boundaries for yourself to re-energize and refresh can alleviate the hectic nature of your life.

say no
realistic expectations

 

Set realistic expectations

Maybe you’re extremely ambitious and want to give your 100% to the 100 things you’re working on. But be mindful of setting realistic goals for yourself, in terms of what you can and can’t control.

 

Have some ‘me’ time

Taking a few hours or days a week to relax and do the things you enjoy can do wonders for your mental health. Read that book you’ve been putting off, listen to a new Spotify playlist or practice meditation.

self care

Try to be positive

We know. How can you be positive when the world is on fire around us. But look for the positive things in your life and the people and things you’re grateful for. Glass half-full instead of glass half-empty..

Maybe you’ve tried all the above and you’re still highly strung out. Talking to a licensed mental health professional can help you manage your stress better. You can speak to one on oDoc today! Download the app now.

Sources:

  • Stress: 10 Ways to Ease Sress, 2020, Cleveland Clinic
  • 10 Stress Busters, 2018, NHS
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