It was indeed a trip to remember. Through the two days going up and down the mountain, I have gone through a lot physically, mentally, and spiritually. I write this down to share what I have gone through and to remind myself of this incredible experience I had. And, praise the Lord for giving me this opportunity of learning.
Mount Kinabalu, located in Sabah, is the highest mountain in South East Asia, and is 4,095.2m above sea level. Usually, people spend 2 days and 1 night to cater for the climb. The first day is to start the climb from the base, the Kinabalu Park Headquarters all the way to Laban Rata, a rest-house located (3,263m) about three-quarters way to the top. After staying there for the night, one would start doing the rest of the climb from about 2am in the morning so as to meet the sunrise at the summit by around 6am. Following that is the trip climbing down to the base, with a brief stopover at Laban Rata again for a lunch. This is what people generally do for the climb.
Every year, as I was told, there is a competition going on to finish the climb from base to the summit and back in the shortest time. The fastest record so far is 2 hours 36 minutes, by a guy from Spain. It is a really, really incredible speed. In contrast, I ended up spending roughly nine (9) hours for the trip up to Laban Rata in day 1, and a record-breaking 17 hours to finish the rest to bring me back to the base in day 2. For your information, my last climbing experience happened some 24 years ago when I was at the Yellow Mountain in China. Needless to say, this one was very demanding to me. But I enjoyed it tremendously.

On September 11, after sorting out all the formalities at the Headquarters, and having a brief breakfast at the nearby caf, I set off for the climb with my personal guide, James, at about 10am. The weather was great, sunny and not very hot, with white clouds and the beautiful blue sky. It didnt take long for me to start feeling the different flavors the trail offers: from those with steps somewhat higher than normal (making it a bit more demanding on the knees), to big rocks scattered in irregular pattern along the path, to big and small rocks. I said to myself quietly, if patience is what I have to learn, I wouldnt miss this golden opportunity.
I was enjoying the scenery and busy shooting and finding the best angle for my lens. Took my brief lunch pack at about 1pm and continued on. By about 2:30pm, it turned a bit foggy and we could feel the humidity around. It was towards 3:30pm that drizzling started and continued to raining heavier and heavier all the way for the rest of the evening and the night. I had my raincoat on which was a fantastic choice because it covered the bag I carried as well. I had a walking stick on one hand and a large bottle of mineral water on the other. The weather became so cold that in two occasions I dropped the bottle of mineral water. Though it was raining, my mood wasnt too much affected because I saw it as more like giving me a variety to my trip.
As it was raining, James and I were walking the path in silence. All I was thinking was to quickly get to the rest-house and have a good rest. I thought James would do too. Towards the evening, the rain becomes heavier and heavier. I felt a world of tranquility and peace. I took the hood off, and let the rain fall on my head. I prayed to God to let the rain cleanse my body and soul.
One thing I noticed was that James the guide had always been keeping a close company with me. When I was doing the photos, he patiently waited. When I was slow in moving the steps, he just took the patience to wait for me and kept at my pace. I said to myself, isnt that supposed to be how the up-lines (in MLM) should take care of the down-lines? So many times, he would show me the easy path, or he would caution me of the likely dangers. I started to see a role model here in my network marketing business. I think I should play the role of a guide, not a teacher, or even a coach.
People kept passing me by, including the young girls from Taiwan, Singapore, China, and some Malaysian as well. I could not but to admit the age factor was kicking in. (I subsequently found out a secret. Actually, most of them had at least a months preparation doing workout etc. to keep fit. No wonder!)
By the time we reached the rest-house, it was already 7pm. We hurried for the dinner and washing up and all that. Before going to bed (sharing a room with 4 others), I made sure that I got my camera and cell-phone batteries recharged.
The guide asked me to wake up at 1am trying to prepare for an even earlier start. Somehow, because the breakfast only started at 2am, we ended up setting off at around 2:30am. This early morning trail could be summarized in a few words: dark, steep, torch, robe, and gloves. Some part of the climbing up is very steep. To a point, my guide said to me and asked me perhaps it was too dangerous for me to persist to the summit. My heart dropped. He said what he said because he saw me having some symptoms of altitude. A couple of times, I was feeling a bit dizzy, and at one point, I felt like wanting to throw up.
I quietly prayed to God and asked Him if I should better stop the climbing up. There seemed a voice in my ear telling me to go on. Doubting that might be because of my own subconscious working, I repeated the question a few times and listened. Yes, the voice spoke the same message and this time it encouraged me to go up because there would be a prize waiting for me. I told James that the Lord asked me to continue. (He was a Christian too).
The rest is history. I got to the summit by about 8am, and had been busy doing some photos along the way. There were not much of a sunrise and people started moving down as we were moving up. Later, we saw a very dim image of the sun when we were hanging around in the summit area. The place was basically bare with not much grass or weed. It was breathtaking because of the elevation, and the grand rocky space it covered. I did a prayer at the top point. The timing and the location had made it unique. To now, I still dont know if a prize is set for me and if so, what the prize is. But, I deeply felt that I have already got the best prize, that is, having God with me.
By the time we got to the summit, most of the people have moved down. The only few that were left behind were the ones who were keen to spot something stunting for the lens, and that included me.
The journey moving down was not as easy as I anticipated. The scenery seemed mostly unfamiliar and I was eager to get to the base as early as I could. The last three hours of the trip down was the most demanding on my knees. I felt the pain coming from my left knee and I could relate that to what arthritis could mean to sufferers. I promised myself I would do everything to make sure I continue to have a truly healthy body till I die.
Finally when we landed on the bridge close to the base, the Kinabalu Park HQ, it was already dark. I paid pity on the four women who were still at least an hour behind. But what could I do?
James was remarkable and very professional. He said he had been working as a guide for the last 16 years. He was extremely patient with me. Perhaps he might look at me as kind of old. I dont know and I wont even ask.
How did I feel when I finally landed at the base? I felt I had accomplished something. I felt like totally worn out. The next thing in my mind was a good meal, a good hot shower, and a good sleep. I remembered I was like dragging my body to the motel nearby. After all, I had a good 17 hours of walking on uneven ground.
This trip has given me a lot to think about. It is a very good challenge to me physically, mentally, emotionally, and spiritually. A few days after the trip, I noticed that I had shed about three (3) pounds of unwanted fat mainly around the waist line, thanks to Mount. Kinabalu.
I would highly recommend the climb to everyone. Would I do it again? Well, I dont think so. I have done it already. At least, not for a long, long while.

Junius Wong

www.OwnYourLifeBlog.com

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Hip arthritis in India affects young and middle aged persons unlike the west where Primary hip osteoarthritis pre dominantly affects the elderly. Surgery in this group of relatively younger patients requires newer techniques and implants. This article will shed light on the disease and the current modalities of treatment available.

Types of Hip arthritis
Hip arthritis is classified as Primary and secondary Osteoarthritis.
Primary osteoarthritis is age related wear and tear arthritis. It is rare in India.
Secondary osteoarthritis occurs at a younger age and is more common. Rheumatoid arthritis, avascular necrosis, traumatic arthritis and other connective tissue disorders like SLE, Psoriasis etc. all lead to secondary osteoarthritis.

Rheumatoid arthritis is an auto immune disorder, affects all joints particularly the small joints but also does not spare the hip and knees.
Avascular necrosis is a condition that reduces the blood supply to the end of the bone. It affects patients with excess alcohol intake, consuming steroids, connective tissue disorders like SLE. Systemic lupus erythematosus (SLE) is a connective tissue disorder affecting mainly young women A photo sensitive rash on the cheeks, renal involvement and arthritis are some notable features. Avascular necrosis affects a proportion of the patients with SLE.
Gauchers disease is a genetic storage disorder.
Post traumatic arthritis occurs after a severe injury to the hip. Fractures of the ball (top of the femur) or socket (acetabulum) can lead to arthritis after inadequate treatment.

Hip arthritis is very disabling as it is a small ball and socket joint unlike the Knee joint which is a large one. In advanced disease a total hip replacement was recommended by Orthopaedic surgeons until recently. Advances in orthopaedic surgery now cater to the specific requirements of these younger patients.

Surgical solutions
These are the mainstay of treatment as conservative measures fail to relieve pain. Total Hip replacement (THR) is a time tested operation and has a success rate of 93 % survivorship at 10 years.
The hip joint may need to be replaced with an artificial joint when it is irreversibly damaged and cannot be salvaged by alternate surgery. The patient complains of pain and restriction of movement. The pain may often be referred to the knee or felt in the knee and no hip symptoms. Occasionally the pain may be felt more in the buttock area rather than in front of the groin.

Who needs a hip replacement?
In India, many young patients with ankylosing spondylitis, avascular necrosis, post septic arthritis, post injury suffer from hip arthritis and are advised a hip replacement for disabling pain. Thus many hip replacement operations are performed in younger patients. The surgery should cater to the enhanced demands on an artificial joint by younger and more active patients. Naturally an operation designed for Western elderly patients is not suitable for younger patients.

What is a total hip replacement?

Fig1. Shows the differences between a normal THR on the left and a Proxima hip on the right

In this operation the ball shaped upper end of the thigh bone (femur) and the socket (acetabulum) are replaced. The ball is replaced with a long metal stem that is fixed into the upper end if the thigh bone. Its upper spherical end articulates with a cup shaped polyethylene socket that is cemented into the pelvis.
Conventional hip replacements sacrifice a great deal of normal bone as the head, neck, and upper part of the thigh bone is removed for implantation of the prosthesis. Moreover wear debris from the poly-etheylene liner lead to osteolysis and bone loss. When this first hip is to be changed or revised after its lifespan more bone loss occurs. Conventional hips have a small ball to reduce friction and wear, but the ill effect of this is an increased risk of dislocation. An average dislocation rate of 3- 4 % has been reported. These implants do not last very longer than 20 years and revision rates of 50% at 20 years have been reported. Survival rates are less satisfactory for the relatively younger active patients. Thus a total hip replacement is not an ideal implant for younger patients less than fifty years old who need a new hip.
Problems with conventional total hip replacement:
Excessive bone sacrifice and loss
Increased risk of dislocation
Patients cannot squat or sit cross legged on the floor with out the risk of dislocation.
Range of movement is less
Patients cannot involve in sports
Poor survival in young and active patients they require earlier revision.
Revision surgery is difficult
The hip feels less like a normal hip
The cup wears with time and plastic from it harms bone
Change in length of the leg after surgery leading to leg length discrepancy.

Why remove normal bone when only the surface of the ball is bad?
This is the logic behind hip resurfacings. This bone preserving hip resurfacing involves replacing only the diseased bony surfaces of the head of femur and acetabulum. This involves sculpting the head of the femur and covering it with a metal cap and fixing an uncemented socket into the acetabulum to receive the head.

Hip Resurfacing- A bone preserving hip replacement!
Preservation of bone and less stress shielding makes it easy to revise this hip if needed. The large head size provides a very stable joint and recreates the sensation of a normal hip joint. Patients have gone back to playing Judo and Squash after this operation. Advances metallurgy makes the metal on metal articulation likely to survive longer in the young and active patient. With less metal inside the bone and less invasion of the medullary cavity of the femur, the risk of infection is reduced. Rehabilitation is faster and better.
Advantages of hip resurfacing:
Allows the patient to squat and sit cross legged on the floor safely
Allows a normal range of movement
Sacrifices only the surface diseased bone and preserves normal bone
Imparts a more normal sensation
The joint is likely to last longer even in younger and active patients.
Earlier and faster rehabilitation
Less risk of dislocation
Easier to revise if needed.
No leg length discrepancy.

Proxima hip replacement A perfect bone preserving hip replacement?
This is the latest addition to the armamentarium of the hip surgeon in India. It is a bone preserving hip replacement.
In this operation, the entire diseased head of the femur is removed. The lining of the hip socket is resurfaced with a metal cup. A tiny uncemented hip with a short stem called the Proxima hip is impacted into the upper end of the femur or thigh bone.

The size of the implant matches the natural one and hence the risk of dislocation is almost eliminated. It is recommended when the bony destruction is advanced and hence unsuitable for resurfacing and a total hip replacement would be overkill. The advantages of the Proxima are
suited for minimally invasive surgery
No thigh pain
Metal on metal confers longevity
Conformity to normal size eliminates risk of dislocation
Ability to correct biomechanical abnormalities makes this superior to resurfacing.
Imparts a more normal sensation
Allows a normal range of movement and normal activities

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No big decision for us! We lived in one of the coldest, wettest cities in the East. We were getting old. Our kids were out of the house, educated and on their own. We both had severe arthritis. My retirement time was approaching, and so was a new winter of our discontent. What would you do?

We put our big, drafty house up for sale. When the deal went through, we had a series of garage and porch sales. Within two weeks, the last piece of clunky 25-year-old furniture was carried out of the house. Even our old cat found a new home with the children of the local mailman’s family. Whatever was necessary for our new life, we packed up in cartons and sent via UPS to the apartment house office in our destination city.

We reluctantly attended my retirement party. We sat through all the boring speeches, took the phony gifts, said fond farewells to some work associates, and final curse-outs to others. By the next morning, we were on the icy, snowy road driving west. The roads gradually improved until we crossed the New Mexico border into sunny, dry Arizona.

That was 15 years ago. Now, we sun, hike and swim every day of the year. We volunteer at local community organizations and, just for fun, we take the one-hour flight to Las Vegas every couple of months. We’re a lot older, but much healthier than the day we left the cold, clammy East.

Our arthritis never flares up, except, of course, whenever we have to travel East for family functions. Did we make the right choice?

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Stenosis back pain originates in the spinal canal itself. Stenosis occurs when the spinal canal narrows, and compresses the nerves inside it. This compression of the nerves can lead to stenosis back pain, numbness in the legs, and the loss of bladder or bowel control. If left untreated, stenosis back pain can eventually become paralysis.

It is estimated that approximately 400,000 Americans currently have spinal stenosis back pain. That number is expected to increase as Baby Boomers age.

Defining Stenosis Back Pain

You probably know that the spinal column protects your spinal cord, a bundle of nerves, from being injured. In spinal stenosis, the spine narrows in one or more of three places: space at the center of the spine; canals where nerves branch outward from the spine itself; a space between the spines bones (vertebrae).

Stenosis back pain occurs when the narrowing puts pressure on the nerves inside the spinal column. Although this can occur in younger people, it is most often a complaint of those over 50 years of age.

Causes of Stenosis Back Pain

Spinal stenosis back pain can be caused by a number of factors.

1. Age is a primary factor. As we age, bands of supportive tissue in the spine may harden and thicken. Our bones and joints may enlarge as they age. We may get bone spurs on the spine places where bone surfaces bulge outward.

2. Arthritis is another cause of spinal stenosis and accompanying stenosis back pain. Either osteoarthritis or rheumatoid arthritis may be to blame. Osteoarthritis is the more common of the two. This type of arthritis usually is seen in middle-aged and older people, and does not go away. Osteoarthritis can cause the bone spurs described above. Rheumatoid arthritis is usually seen in younger people, and is not usually a cause of spinal stenosis back pain.

3. Inherited factors may also lead to stenosis and stenosis back pain. Some genetic conditions, such as a small spinal canal or curved spine, can cause spinal stenosis.

4. Other causes for your stenosis back pain could include calcium deposits, fluoride accumulation, or injuries.

Symptoms of Stenosis Back Pain

Stenosis back pain usually occurs in the neck or back. In addition to the stenosis back pain, you may feel pain down one leg, or numbness, weakness, cramping, and pain in legs or arms as the nerves are compressed.

Stenosis Back Pain Test Problem

The problem with tests for spinal stenosis is that the conditions shares symptoms with so many other disease. The result has too often been costly misdiagnoses and unnecessary back surgery, according to Andrew Haig, M.D., associate professor in the Department of Physical Medicine and Rehabilitation at the University of Michigan Medical School.

The following 3 tests are used to diagnose the cause of stenosis back pain.

1. Magnetic resonance imaging (MRI) radio waves to picture the spine

2. Computerized axial tomography (CAT) X-ray series to picture the spine

3. Electromyogram (EMG) a test that not only gives a picture of nerves, but also tests nerve function, showing if there is actual nerve damage

Best Stenosis Back Pain Test

Of the three, the oldest, Electromyogram (EMG) has been found to be the best. This test has been around as long as, or longer than the Baby Boomers themselves, but a study published in the January 2006 issue of Spine shows that it is by far the best of the three tests.

That study, done by the University of Michigan Health System, shows that the EMG test accurately determines the cause of stenosis back pain. As a result, low back pain is less likely to be misdiagnosed, as are other common neuromuscular conditions with similar symptoms. Back surgery undertaken to cure misdiagnosed stenosis back pain can be avoided with this stenosis back pain test.

Tests done in the U of M study by Dr. Andrew Haig and his colleagues showed a substantial difference between those who have spinal stenosis and those with other types of back pain. It showed that use of the EMG allows experts to clearly distinguish between spinal stenosis and low back pain.

“Most doctors think of EMG as a simple test and incorrectly believe that it is sensitive for nerve damage, but cannot differentiate spinal stenosis form neuromuscular disease,” explains Haig. “But as this study shows, that’s not the case. In fact, EMG is an excellent test for spinal stenosis and other neuromuscular disorders using strict evidence-based criteria.” (Spine, Vol. 30, No. 23)

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Shih Tzus are known as energetic, playful and has lively personality. Once you notice something strange with your Shih Tzu’s behavior, you can be sure that he is feeling something different. Is he not as active as he is used to be?

Check out because he might be suffering from hip dysplasia. Hip dysplasia is a joint disease in animals, commonly found in dogs than in cats. Some says dysplasia is a genetic disease; some describes it as a developmental disease. Whether a genetic or a developmental disease, the fact remains that it is a disease thus something must be done to treat it.
But before taking steps in treating this disease, it is important to fully understand what hip dysplasia is. Hip dysplasia is a condition wherein there is abnormality in the hip joint of a dog. It could affect left, right or both legs. In a dysplastic hip, the ball and the socket do not fit together resulting to damaging and painful friction. Most dogs with dysplasia are born with normal hips but because of genetics and other factors, the soft tissues that surround the joint start to grow along with the puppy.

So how will you know that a dog has dysplasia? Some puppies, as young as five months old will may experience symptoms such as difficulty in rising, lameness in the back legs soreness after lying down and after heavy exercise and reluctance to jump or stand on hind limbs. The usual active and energetic Shih Tzu may now have less energy and movement. They oftentimes avoid activities that involve much movement and energy. This disease if left untreated can lead to arthritis. And as time goes by, the dog may even need assistance in getting up or worst, may cripple the dog for life.

It has been said that dysplasia is an inherited disease. Yes, dysplasia is passed on through genes and develops over time. It may not be evident at once but it can be triggered by obesity, improper nutrition and other factors as well. Not all dogs with hip dysplasia show no signs of disease. The risk is that, these dogs may be included in a breeding program thus prevention of the disease can be impossible.

This disease, as much as it can be prevented can also be treated in many ways. These treatments include pain medications, weight loss programs especially for obese dogs, controlled exercise, good nutrition and physical therapy. But if the prior mentioned treatments are found ineffective especially in worst cases, another option is surgical treatment.

Dysplasia is a disease of large breed of dogs however, medium and small sized dogs such as Shih Tzus, is not exempted from being affected with this disease of the joint. It can be passed on through genes so it is important take extra care in breeding programs.

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