Almost forgotten

This month is CERVICAL CANCER AWARENESS MONTH

So tomorrow, I will share my experience with cervical cancer survivors

Cervix/cervical = Neck of the womb
Cancer = abnormally growing cells not functional together with body

If >20yo ladies, had ur pap smear yet?
Prefer my sharing in:
Lebih suka jika saya berkongsi dalam:
Wah, betul2 seri.
Jadi saya akan pilih BM
sebab ini kan twt_malaysia
bukan twt_inggeris

Pap smear bukan untuk yang kahwin saja.

Sesiapa yang pernah seks vaginal akan terdedah kepada jangkitan virus HPV (human papiloma virus).

HPV penyebab barah pangkal rahim (kanser serviks) 90% ke atas

Ujian pap smear memerlukan pemeriksaan spekulum (alat menjarakkan vagina untuk meneliti pangkal rahim) maka tidak sesuai untuk anak dara yang masih berselaput hymen (selaput anak dara)

Sekarang dunia dah beralih ke ujian HPV dalam pangkal rahim tetapi ujian ini diambil sama seperti pap smear tetapi kos lebih tinggi dari pap smear
Ketepatan lebih tinggi maka boleh menjarakkan ujian saringan seterusnya selepas 3-5 tahun
Ada juga ujian HPV tanpa pemeriksaan spekulum yang wanita boleh DIY buat untuk sendiri

Google Project ROSE untuk maklumat lebih

Image
3 Sebab Kanser Serviks (Barah Pangkal Rahim) patut dicegah?

1 Libatkan wanita berumur lebih mudah (30-40tahun)
2 Senang dicegah melalui saringan HPV/pap smear + vaksin HPV
3 Kanser merebak lambat, rawatan awal melibatkan pembedahan kecil Image
Untuk gadis yang lebih 11tahun, sudahkah anda mendapat vaksin HPV (Gardasil atau Cervarix)?
Promosi Webinar

Dalam 15 minit lagi!
Kawan saya Lt Kol Shazni on air Live
Bagi ilmu percuma!
#kirimkhabaruntuksaya
#siapcepatdiadapat Image
Lifetime protection of HPV vaccine:
Assuming female lifespan till age 80yo, that's 30years of protection

Hence, RM1500÷30yrs
= RM30 per year
= 8.2 cents per year

Baru habis klinik pagi

Satu lagi kanser serviks dielakkan

Pesakit 30+tahun dirujuk kepada saya kerana pap smear mengandungi sel tidak normal dan HPV risiko tinggi positif

Kon biopsi serviks menunjukkan CIN2 (prakanser tahap2) dengan sempadan sel yang normal
Teringat dua pesakit saya yang menghidapi kanser serviks

Satu sudah meninggal
Satu sudah berjaya menumpaskan kanser

Saya mulakan dengan cerita sedih dulu

Sila bersedia kertas tisu
Pesakit ini berumur 30+ tahun, seorang usahawati yang berjaya& apabila dapat kanser, tidak dapat menghadapi kenyataan dan mencari beberapa doktor untuk kepastian tetapi hakikatnya sama

Dia tidak menjalani rawatan, malah bercuti luar negara sebulan
Lepas cuti, tiba2 pengsan dan masuk wad dengan hemoglobin 2.5 (sel darah merah,normal 11 ke atas)

Lepas transfusi darah,dia pergi majlis tahunan di KL demi mengambil anugerah atas kejayaan perniagaannya

Lepas majlis tersebut,dia menjadi tenat dan meninggal lepas beberapa minggu
Vaksin diluluskan dari umur 9 sehingga 45 tahun

Hanya jika tidak pernah seks, maka 101% tiada terdedah virus HPV, faedah vaksin LEBIH TINGGI

Yes, take it early

Most private clinics and all obgy clinics should have

Call them to find out the availability

Balik ke cerita pesakit kedua yang berjaya melawan kanser serviks 💪💪💪

Auntie ini 60+ tahun, tetiba periksa tekanan darah, didapati tinggi. Jadi doktor merawat dengan ubat

Lepas beberapa minggu,sakit pinggang kuat dan pengsan

Masuk hospital, rupa2nya buah pinggang bengkak!
Ni plottwist tahap gaban ni

Kenapa ginjal bengkak air?
Sebab ada bengkak di serviks!

Apa kaitan? (Lihat gambarajah)

Mulanya,tgk doc ginjal (nephro)
Doc ginjal stabilkan keadaan
Rujuk pakar bedah salur kencing (urologi),masukkan stent ureter (salur dari ginjal ke pundi kencing) Image
Pada masa sama,saya periksa serviks, ambil biopsi dan sah
Kanser Serviks

Peringkat (Stage) 3 kerana dah melibatkan saluran kencing (dari ginjal ke pundi kencing)

Prinsip rawatan kanser serviks ialah ikut Shakespeare: To be or not to be!

Piang! Ape shakespeare pulak?
Maknanya to be or not to be atau
2b atau bukan 2b

Jika peringkat 2b ke bawah, lebih baik bedah dulu sebelum kemoterapi dan radiasi

Dan sebaliknya, jika 2b dan ke atas

Sebab kajian menunjukkan prinsip ini yang paling efektif lawan kanser dengan risiko paling rendah
SELINGAN: APAKAH BEZA STAGE, GRADE AND CELLS TYPE?

Stage (Peringkat): Sejauh mana kanser merebak?
Stage 1 biasa dalam organ, 4 dah keliling dunia

Grade (Gred): Berapa cepat kanser merebak? (Biasanya tgk nukleus & daya biak sel kanser) Gred 1 cepat biak,Gred 3 sgt cepat biak
Cells type (Jenis sel): Pelbagai jenis sel kanser, biasanya sel kanser serviks itu squamous sell (sel kempis macam bantal) dan lebih sensitif radioterapi. Jika sel lain macam round cells dll, lebih agresif
Jadi,ikut Shakespeare,auntie 60thn melalui kemoterapi dan radiasi di serviks

Habisnya beberapa kitar rawatan, Ct scan dan petscan nampak kanser sudah kecut sampai nyaris tak nampak

Auntie 60thn ok je. Sempoi

Padahal,banyak umur 30-40thn,tak mau buat kemoradiasi sampai tlambat
Seterusnya,auntie bincang dengan pakar kanser (onkologi)&rujuk balik saya utk buangkan rahim,kilang telur&salur limpa pelvis utk pastikan semua dikosongkan

Pembedahan siap!

Selepas 6 bulan,PET CT scan&pap smear ulangan menunjukkan tiada lagi sel kanser serviks!

@gynaepenang
Lokasi berbeza

Kanser ovari biasanya tiada gejala, bila dijumpai sudah peringkat 4 maka hanya 3 dalam 10 pesakit masih hidup lepas 5tahun,tiada ujian saringan tapi kurangkan risiko dgn ujian ultrasound setahun sekali atau buat ujian genetik utk gene BRCA

Image
Semua kanser ada risiko serang balik sebab memang keadaan badan sendiri "subur" untuk bertumbuh sel kanser

Maka peringkat 1 lebih senang dirawat dan kurang risiko atau lebih lambat diserang balik jika cara hidup sihat (bersenam,tak rokok,makan sayur buah)

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More from @twt_malaysia

24 Jan
Then, why obstetricians are more inclined to do Caesarean Sections rather than conduct Normal Deliveries or some docs totally stop seeing pregnant patients?

Personal choice
or push by public pressure?

Find out in subsequent tweets

(thread)
1 Unpredictable hours of childbirth
Preggies can go into labor at anytime and deliver at anytime, even at 2-3am at night as compared to elective preplanned CSection

And when in labor,docs need to hang around in the hosp or extremely nearby (locked up personal time)
2 Ultrasound,antenatal test & in labor CTG cardiotocogram are NOT reliable in determining baby's health

Hence,moms who refused genetic check may end up hvg genetically handicapped baby but blamed it on birth process

In court,lawyer will ask "Why CSection wasn't done earlier?"
Read 6 tweets
23 Jan
TOP 8 POINTS IN COVID19 PRIVATE-PUBLIC INTEGRATION
by Dr Low Kah Pin @gynaepenang

Disclaimer: I am a gynae,
NOT public health expert,
NOT epidemiologist
NOT infectious disease specialist
NOT covidologist

But here's a few things I wanna pen down since I am curating (alang2)
1 Private hospitals all prepared to help out in pandemics since EARLY 2020, to take over non-covid patients as CSR corporate social responsibility program

Thus,there is NO need for darurat in 2021 to nationalize private hospitals
2 Rumors: Reason to open up private hosps for covid19 patients was enable VVIPs (read: Ministers) & supertycoons who not keen to be admitted to public hosp or quarantine centre ie MAEPS

Not all GHs are filled up fully by covid patients
Many GHs just turned hybrid lately
Read 9 tweets
23 Jan
After Trump stepped down, Bernie is the famous one!

Meme is no joke!
Bernie's reaction?

 “I was just sitting there trying to keep warm, trying to pay attention to what was going on.”

“What was really nice is the woman who made the mittens lives in Essex Junction, Vermont, she is a schoolteacher and a very, very nice person." #Berniememes
Read 4 tweets
22 Jan
Good morning, all!

Just another working Saturday for me

But first, morning walk with my usual morning symphony
The huge shady old big trees along the road was massacred yesterday

The fresh sawing wounds were clearly seen

This road is secluded and only used by less than 10 residents of houses here

Took a many years to grow a tree
One day to chop it down

Penang City Council, why? Image
Blinking back:
Today's @blinkist Blink's about Trevor Noah's "Born A Crime"

He maybe a straightfaced famous standup comedian to you but his childhood and life is an amazing tale of a survivor of an apartheid regime as a mixed child Image
Read 4 tweets
19 Jan
Morning walk with Mr Slow

Walking my pet this morning.. haha

Now, what about FIBROIDS would you ladies wanna know? Image
In simple term,

Fibroids are muscular swelling in the wombs Image
How many ladies has fibroids?
Read 22 tweets

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