5 GOLONGAN YANG SUKA MINTAK MC

Penulis asal Mohd Syamirulah Rahim

Hari ini saja saya nak menulis mengenai M.C (Medical Sickness Certificate). Selalunya jarang doktor menulis mengenai MC kerana ia ibarat membuka pekung pesakit pula. Tapi saya berpendapat, kalau tak dikongsi, macam mana orang nak tahu, betul tak?

MC adalah sebuah topik yang agak sensitif, kerana ianya melibatkan expectation. Maklumlah, selalunya orang datang ke klinik berjumpa doktor, dia dah set dalam kepala siap-siap

“Aku datang hari ini berhajatkan MC”.

Maklumlah, dalam banyak-banyak ubat yang ada, inilah ubat yang paling mujarab. Bebas bahan kimia. Dengan ubat ini, hilang segala sakit kepala, sakit perut, sakit belakang, sakit-sakit badan dan pelbagai jenis sakit lagi.

Biar lah berkhilaf berbeza pendapat bab vaksin, bab bersalin homebirth, bab aurat pesakit, bab halal haram, bab mitos etc…tapi insyaallah setakat ni tak ada lagi org berani nak persoalkan bab MC.

Justeru bila doktor tak bagi, maka pesakit ini rasa kecewa. Rasa dikhianati. Rasa membuang masa datang berjumpa doktor. Segala sakit tadi, hilang berubah menjadi sakit hati. Rasa penyakitnya ini tak akan sembuh, sampai sanggup ke klinik lain untuk dapatkan ubat mujarab ini.

Kerana itu sesama doktor, ada istilah “MC Seeker”. Betul, istilah sebegini tidak berapa elok digunakan, kerana secara tidak langsung ia menggambarkan sikap doktor yang suka melabel pesakit. Namun, its there for a reason. Sebab it’s a cliche.

MC-Seeker adalah individu yang sebenarnya pada hemat kita (doktor) setelah diperiksa, kesihatannya memuaskan dan layak untuk bekerja, tetapi tetap mahukan MC.

Jom kita tengok sikit beberapa jenis MC-Seeker;

1. “Macam-macam ada”.

Kita doktor, bila kita bertanyakan pesakit, soalan-soalan yang kita tanyakan seringkali berangkai atau berkaitan. Tujuannya adalah untuk kita explore sejarah pesakit, sekaligus dikaitkan dengan diagnosis tertentu.

Kadang2, kita guna cara ini untuk mengenalpasti MC-Seeker.

“Doktor, saya datang ini sebab sakit kepala.” sambil muka berkerut-kerut.

“Cirit birit, ada?” – ada, doktor.
“Kencing lawas tak?” – lawas, doktor.
“Kentut ada masalah?” – kadang-kadang ada, doktor.
“tangan ada rasa macam lenguh-lenguh?” – ada, doktor.
“telinga ada rasa macam gatal-gatal?” – aah, ada, doktor.

Biasanya MC seeker ini, dia akan mengatakan ya kepada majoriti soalan bagi menggambarkan keseriusan penyakit.

Soalan-soalan yang ditanyakan ni sebenarnya jarang berkaitan dengan sakit kepala pun. Tapi sengaja kita tanya, hendak tahu apa respons pesakit. Selain ia boleh membantu kita dalam diagnosis, dalam masa yang sama, kalau asyik tidak logik sahaja jawapannya ia turut membantu kita mengenalpasti MC-Seeker.

2. “Tak Mahu Prosedur”

Selalunya MC-Seeker ini, bila datang dengan hajat tersendiri “aku datang nak ambil MC”, automatik dia beranggapan nak setel cepat-cepat. Dia akan menolak prosedur dan memberikan pelbagai alasan.

Sebagai contoh,

“Doktor, saya datang ini sebab batuk kuat, sampai berdarah kahak!”
“Kalau gitu saya kena minta untuk ambil sampel darah, buat xray, dan ambil sampel kahak.”
“Eh xpelah doktor, saya datang nak ambil ubat je. Oh ye, MC jugak ye doctor.”

3. “Bawak bodyguard”

Fuhhh…yang jenis ni antara yang paling mencabar. Kebanyakan kes nak minta MC, selalunya datang sorang. Sebab dia tahu kat luar klinik, dia sihat je. Segan nak berlakon depan doktor.

Tapi ada yang jenis berpakat, datang berteman. Tak kira lah bawak girlfriend/boyfriend ke. Ada yang siap bawak mak sekali (biasanya kes mak yang suruh mintak MC sebab nak minta anak drive pegi somewhere).

Jenis yang bawak bodyguard ni yang selalu payah sket. Sebab bila kita kata “sakit encik/puan ni tak perlukan MC,” yang bodyguard ni akan tiba-tiba berubah jadi lawyer pesakit.

“Punya tak larat dia kat rumah, doktor kata tak boleh MC?”
“Habis macam mana dia nak pegi kerja?”
“Bulan lepas saya bawak anak saya seorang lagi, boleh ja dapat MC?”

4. “Bos suruh mintak”

MC Seeker jenis ni selalu meletakkan doktor dalam keadaan serba salah.

“Tapi saya memang tak datang kerja hari ini. Bila bagitahu supervisor, supervisor suruh minta MC!”

Selalunya saya malas nak bertekak dengan pesakit, saya akan jawab secara jujur sahaja – “Kalau begitu, minta lah MC dari supervisor awak.”

Kita kena faham, dalam mana-mana perkhidmatan sama ada awam atau swasta, soal cuti adalah antara pekerja dan majikan semata-mata. TIDAK melibatkan doktor.

Anda sepatutnya dapatkan pengesahan doktor (MC) dahulu, baru berbincang dengan majikan. Ini kerana, hak memberi cuti tetap terletak kepada majikan. Kalau doktor mengesahkan anda sihat, tapi anda sudah “tercuti” pada hari tersebut, anda kena lah bincang dengan majikan. Doktor hanya boleh berikan time slip.

Cuti ini bukan MC sahaja. Cuti rehat, cuti kecemasan, cuti tanpa rekod pun ada. Kalau anda datang klinik pada malam hari, minta MC tapi doktor tak bagi, terpaksa lah tukar cuti anda jadi cuti tanpa rekod/gaji. Anda tak boleh lah nak desak doktor bagi MC juga atas alasan “taknak cuti kena potong”.

Doktor beri MC atas faktor kesihatan pesakit. Bukannya faktor berapa baki cuti rehat anda.

5. “Pelakon terhebat.”

Sesetengah klinik, dilengkapi dengan CCTV yang mana doktor didalamnya boleh melihat gerak geri pesakit di ruangan menunggu melalui komputer.

Pesakit jenis ini, seringkali menggayakan aksi exaggerated (berlebihan). Contohnya di ruangan menunggu rileks sahaja senyum2 sambil melihat phone, berbual dengan teman (bodyguard).

Tapi apabila tiba giliran untuk memasuki bilik doktor,

Batuknya mengalahkan orang asthma. Gaya berjalan serta merta menjadi terhincut. Tangan yang tadinya memegang henset, kini beralih memegang perut yang sedang memulas.

Kadang2 doktor tak tengok pun. Tapi doktor ada spy. “Patient yang doktor bagi MC tadi tu, happy je keluar dari bilik doktor. Terus menuju ke parking, tak singgah farmasi pun.” ujar misi check BP yang duduk kat luar klinik. Dah selalu dah doktor kena tipu macam tu.

Perkongsian sebegini hanyalah sekadar untuk pengetahuan am sahaja, jangan lah ambil serius sangat. Bagi kes-kes yang betul-betul tak sihat, doktor tiada masalah mengeluarkan MC. Bahkan doktor sendiri akan offer MC jika beliau dapati kesihatan pesakit tersebut boleh membahayakan pesakit ketika bertugas.

Contohnya, kes pneumonia yang pernah saya jumpa.

“Cikgu betul ni, tak mahu MC? Demam tinggi tu, 39 darjah celsius. Batuk pun sampai tak ada suara, macam mana nak mengajar?”

“Takpe doktor, saya banyak nak setelkan kerja, nak key-in markah, siapkan laporan. Lagipun dua tiga hari ini ada mesyuarat, tak boleh cari orang ganti!”

“Eh jangan macam tu, cikgu. Saya bagi cikgu MC tiga hari, untuk cikgu makan antibiotik dan rehat secukupnya bagi sembuh dulu. Jangan tambah rungsing fikir pasal kerja, kelas dan sebagainya!”

Ingat, urusan cuti (termasuklah MC) adalah hak majikan. Doktor hanya memberikan saranan dan pendapat perubatan, tetapi jika majikan tetap meminta anda bekerja, anda perlu berurusan dengan majikan.

Untuk pengetahuan, ini yang selalu berlaku kepada kami di bahagian kesihatan atau para doktor sekalipun. Kalau ikut logik, kami lah golongan yang paling banyak MC sebab kami tahu macam mana nak dapatkan MC, bahkan senang nak “kawtim” sesama rakan.

Hakikatnya, tidak. Doktor dan staf kesihatan lain, seringkali walaupun dengan MC, tetap diminta datang bertugas khasnya seperti tujuan oncall. Ini kerana, kelulusan cuti tetap tertakluk kepada kepentingan perkhidmatan, atas penilaian ketua jabatan/majikan.

 

Kredit : Himpunan Cerita Lawak, http://kakitrending.com/5-golongan-yang-suka-mintak-mc/

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Normal blood pressure according to your age

Hypertension: Definition: Systolic pressure above 140 mm Hg or diastolic pressure above 90 mm Hg.

In order to establish the diagnosis of hypertension , blood pressure measurement must be repeated in a calm state over time. The precise interval between measurements over what period of time is not clear. Regulating your blood pressure is a vital question and it can become a real virtue. Hypertension is also called silent killer so if you are an older person and unable to regulate your blood pressure  so than it might be pretty harmful and sometime impossible. A study of more than 2, 000 seniors published online in the Archives of Internal Medicine show the surprising results.
Blood pressure affects the function of the kidneys, arteries, and the entire body. If not regulated on time, it causes great damage to the arteries, and the other body organs, leading to heart attack, kidney failure, heart failure, and numerous other health problems.This explains why most doctors decide to treat hypertension with an aggressive approach, in order to bring down high blood pressure.This is a list of 10 symptoms which indicate high blood pressure:
1. Poor circulation
2. Headache
3. Lightheadedness or dizzy spells
4. Difficulty breathing
5. Pounding in the ears and neck
6. Numbing sensation
7. Nosebleed
9. Impaired vision
10. Blood in urine

More about the symptoms of high blood pressure:
If you experience any of the above mentioned symptoms you need to consult your doctor and get tested to determine the best course of action. You can use some natural ingredients like Hawthorne, omega 3 fatty acids and potassium to lower your blood pressure without medications, they are very effective. When you go see your doctor he’ll recommend the best therapy for you. The DASH diet (Dietary Approaches to Stop Hypertension) is a really effective way to preserve your health and lower high blood pressure naturally. Numerous studies have shown that natural remedies can significantly reduce the need for hypertension medications.

You can get your blood pressure back to normal by exercising in moderation, reduce the intake of sodium and follow a healthy eating regimen. One recent clinical trial showed that reducing the sodium intake can significantly lower high blood pressure, but still everything points out to the fact that the DASH diet is the most effective method to eliminate hypertension.
DASH diet
1. Low fat dairy products
2. Consuming more nuts, grains, fish and poultry
3. Fresh foods and vegetables
4. Avoiding high cholesterol and fatty foods

The lucky ones can resolve their hypertension problems completely naturally, by exercising more, eating healthier and reducing the sodium intake. Others still need to take certain medications to prevent bigger complications. You need to consult your doctor and see whether a completely natural approach will suit you or you need to take another course of action. The case may be, a healthier lifestyle can improve your overall health in general, so you should consider making some changes regardless what your diagnosis is. For this article, the purpose is to show you how to control high blood pressure, since the methods vary in the fifth and the eighth decade of life. Generally, health providers tend to chart blood pressure changes, and start following their results since they’re 20.Getting an exact picture of the patient’s blood pressure and charting what happens over time is what healthcare providers will want to do.

 

It all starts at age of 20. The AHA (American Heart Association ) reveals young people to screen their blood pressure at their regular healthcare visit. This happens once in every 2 years and applies to those whose blood pressure is lower than 120/80 mm Hg.Yet, blood pressure rises with heart beats and falls down between the beats. It is also affected by stress, sleep, posture, and physical activity. Yet, despite all these changes, the blood pressure should be lower than 120/80 mm Hg (which is less than 120 systolic and less than 80 diastolic).Sadly, 1 in 3 American adults suffers from high blood pressure. In this case, doctors read the blood pressure over time, or may advise a monitoring at home, before they diagnose high blood pressure.

 

You should take in mind that a single peak, a single high reading does not necessarily mean that you are dealing with high blood pressure. But when it comes, that your readings maintains values of 140/90 mm Hg or above (systolic 140 or above OR diastolic 90 or above) over time, your doctor will recommend you to begin with a treatment program. Almost in every case these programs include lifestyle changes, diets and usually prescription drugs for individuals with that kind of problem-with readings of 140/90 or higher.

To ensure you have correct results, if the systolic values stands at 180 mm Hg or higher, and the diastolic value is 110 mm Hg or higher when monitoring, you need to repeat the procedure after a couple of minutes.If subsequent results are the same, you’re advised to seek medical help.Keep in mind than even if your blood pressure is normal, take some new lifestyle changes to protect your health and to improve your heart health. This will absolutely help you improve your overall health.

Difference Between HDL and LDL

Known as lipid, cholesterol is a fatty substance found naturally in the body. It is mainly made by the liver but it is also present in the food you eat. Your body needs cholesterol to function properly, as it is present in the membranes of every cell in the body, including the brain, muscles, nerves, liver, skin, heart, and intestines. Cholesterol is not water-soluble and cannot travel freely in your blood unless it pairs itself with proteins to form lipoprotein, which helps transport cholesterol through your bloodstream. Lipoproteins can be divided into two categories – one is low-density or LDL and the other one is high-density or HDL. Although both types of lipoproteins help transport cholesterol, they are not the same.

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Main Difference Between HDL and LDL

It may seem that both HDL and LDL play the same role in the body, but that is not the case. In reality, they both have very different functions, structures, and effects on your health.

1.        Difference in Functions

Both types of lipoproteins transport cholesterol in the blood, but there is functional difference in how they deliver cholesterol to different parts of your body.

  • LDL (Bad): LDLs are the primary carriers of cholesterol and take cholesterol to cells in your body. They can lead to plaque, so is considered bad for your health. Plaque is a thick, hard deposit that can cause blockage in arteries and lead to a condition called atherosclerosis. Sometimes, a clot forms in a narrowed artery and cuts blood flow, which results in a stroke or heart attack. Excessive plaque buildup in an artery supplying blood to the legs may contribute to the development of a condition called peripheral artery disease.
  • HDL (Good): One major difference between HDL and LDL is that HDL has good effects on your body because it plays a big role in eliminating bad cholesterol from your arteries. It works as a scavenger and takes cholesterol away from your organs and heart. Then it delivers cholesterol back to your liver, where the cholesterol is broken down and eliminated from the body. It is important to have a healthy level of HDL cholesterol in your body to stave off cardiovascular disease, including heart attack and stroke.

2.        Difference in Structure

The structural difference between HDL and LDL is the composition of lipids and proteins

  • L: In terms of weight, 50% of LDL particle is cholesterol and 25% is protein. There is also a difference in the types of proteins present in HDL and LDL. Proteins called B-100 are present in low-density lipoproteins.
  • HDL: In terms of weight, HDL particle consists of 50% protein and 20% cholesterol. Protein is denser as compared to fat, which is why HDL particles are denser as compared to LDL particles, which is why HDL particles are called “high density”. HDL particles mainly consist of A-I and A-II proteins. The function of these particles changes due to a change in the types of proteins they contain.

How Much Cholesterol Is Too Much?

Doctors recommend that you should aim to keep your total cholesterol levels below 200 mg/dL. While less than 200 mg/dL is desirable, you are also safe between 200 and 239 mg/dL – although it makes you more susceptible to developing heart disease. Anything above 240 mg/dL is considered high.

You are at a serious risk for stroke, heart attack, and other problems if your LDL cholesterol levels are higher than 190 mg/dL. However, you need to aim for a higher level of HDL cholesterol because anything less than 40 mg/dL puts you at a greater risk for heart disease. Your doctor will consider your age, your medical history, and your blood pressure to determine the best lifestyle changes and medications to keep your cholesterol within the desirable range.

How to Lower Cholesterol Levels

Knowing the difference between HDL and LDL will always put you in a better position to understand how to maintain a balance between both types of lipoproteins. However, you can make some lifestyle changes to keep your cholesterol levels in check. For instance:

  • Include food in your diet that contains less cholesterol, fat, and saturated fat.
  • Avoid eating the skin and fat from poultry, meat, and fish.
  • Avoid eating fried food and opt for baked, broiled, or poached food.
  • Include lots of veggies and fruits in your diet.
  • Eat whole wheat bread and rice or cereals made from whole grain.
  • Consider losing weight if you are obese.
  • Quit smoking.
  • Stay active and do moderate exercise for about half an hour every day.
  • Always take your cholesterol medications carefully, as per the instructions of your doctor.

 

Reference : http://www.medicalonline1.com/2017/05/27/difference-between-hdl-and-ldl/

Buang air besar sejurus selepas kita makan

Kebanyakkan daripada kita mesti merasakan nak buang air besar sejurus selepas kita makan. Ada yang beranggapan najis yang ingin dibuang itu merupakan makanan yang baru sahaja diambil sebentar tadi. Sebenarnya bukan itu yg berlaku.

Kami ingin menerangkan beberapa perkara:

1. Makanan yang baru dimakan akan melalui saluran pencernaan sepanjang lebih kurang 9 meter bagi orang dewasa. 9 meter ni bukan pendek ye tuan puan. Mustahil makanan yg baru masuk itu dpt bergerak dgn cepatnya melalui tempat-tempat yang berbeza(esophagus, perut, usus kecil, usus besar) dan terus kebahagian anus(dubur).

2. Perasaan ingin membuang air besar itu berlaku disebabkan badan kita mempunyai suatu reflex yg dipanggil sebagai Gastro-Colic Reflex.

Dalam reflex ini, apabila kita mengambil makanan dan makanan masuk ke dalam perut(nama lain bagi perut adalah Gastric) maka akan ada satu reflex terhasil iaitu pergerakan ‘peristalsis’ di usus besar(nama lain bagi usus besar adalah COLON).

Oleh itu, najis yg keluar itu adalah makanan yg kita makan sebelum itu lagi, bukan makanan yg kita baru sahaja makan. Sebab itu kita panggil sebagai Gastro(bermaksud perut) – colic(bermaksud usus besar) reflex.

3. Begitu juga dalam kanak-kanak yg cirit birit. Ada ibubapa yg risau selepas anaknya makan sahaja, anak itu cirit. Mereka beranggapan makanan yg baru kanak2 itu makan terus dicernakan menjadi cirit.

Sebenarnya tidak. Najis itu adalah makanan yg kanak2 itu makan sebelum ini. Bukan yg baru sahaja dia makan.

Harap bermanfaat

Sumber gambar: https://crohnsdisease.com/living/the-gastrocolic-reflex-food-goes-right-through-me/

Sumber Penulisan : http://rootofscience.com/blog/2016/kesihatan/perubatan/kenapa-kita-rasa-nak-buang-air-besar-sejurus-selepas-kita-makan/