Pills, pills, pills

AGE WELL
By DR YAU WENG KEONG

The practice of prescribing too many medications (polypharmacy) to elderly patients has many pitfalls.

NOT too long ago, a doctor wrote about his unforgettable elderly patient who presented to him with giddiness. The patient had a note with a list of drugs, the reason for the drug and by whom it was given. They were as follows:

·Drugs A, B, C and D prescribed by Dr Hart, cardiologist, for heart disease

·Drugs E, F, G and H prescribed by Dr Bone, orthopaedic surgeon, for diabetic foot

·Drugs I, J, K and L prescribed by Dr Glen, endocrinologist, for diabetes

·Drug M was prescribed by all his doctors and he mentioned that it was the most bitter pill to swallow.

Most doctors and patients have been in such sticky situations where polypharmacy (the practice of prescribing too many medications) occurs, with no solution in hand. Elderly patients truly need many drugs as they often have multiple co-existent medical conditions. Sorting out these medical conditions is difficult as they are complex and the symptoms can be hidden, atypical or altered.

Elderly patients have ageing changes which lead to diminished organ reserve (poor adaptation), and this results in vulnerability to diseases and abnormal physiological responses. These aged-related changes sometimes get confused with an actual disease process. Given the difficulties in proper assessment (and correct diagnosis), it is sometimes easier to pacify elderly patients by prescribing drugs rather than engaging in detailed explanation and collaborative decision making about the multiple complex diseases they have.

The decision to not prescribe is a difficult one to make. In many cases, patients are prescribed drugs to console (patients and doctors) plus to “protect” the doctors themselves. Many decisions about medication therapies are frequently made without older patients’ input too. This causes patients to adhere poorly to taking medications, especially those with chronic illnesses with no symptoms, for example hypertension and high cholesterol.

Nowadays, the elderly are getting healthier and they do live longer. The threshold for treating risk factors to prevent diseases is rightly lower. Educated patients will also demand for the latest technologies and newer or better drugs.

Some patients may oppose to the discontinuation of a certain drug even when the drug is clearly unnecessary or the symptoms for which it was prescribed have long since disappeared. Self-medicating, failing to follow prescribed directions, failing to report all drugs (especially over-the-counter drugs), and borrowing or trading medication with other persons worsen the situation. It is common too for Malaysian patients to go doctor-shopping and get advice from traditional healers. This can be potentially disastrous.

Dangers of polypharmacy

Polypharmacy is a widespread problem with many (doctors, pharmacists, patients, caregivers etc) culprits. Still, it is necessary to prescribe as drugs, when prescribed appropriately, will increase quality of life and reduce complications, disabilities and handicapping conditions.

Elderly patients have aged-related decrease in physiological organ reserve, impaired homeostasis mechanisms and chronic illness. This makes them more vulnerable to unwanted adverse outcomes with medications. The more drugs patients take, the greater the risk of unwanted adverse effects, and poorer compliance too.

It will be more costly too and patients may be hospitalised from adverse events. A large proportion of adverse reactions are due to drug interactions, which includes drug-drug interactions, drug-nutrient interactions, drug-alcohol interactions and drug-patient interactions. OTC and traditional medications worsen the problem.

How can we prevent polypharmacy?

Like a good song where there is a need for both good lyrics and music, both the doctors and the patients and their caregivers must perform their roles appropriately. Doctors must always ask themselves the question, “Will this treatment lengthen or improve the quality of this patient’s life?”

The emphasis on treating people and not just managing their “outcomes” or the disease is one of the strengths of geriatric care. Ignoring this puts doctors at risk of “not seeing the forest for the trees!”

Doctors must ask themselves if each medication is necessary or contraindicated and all medications should be reviewed regularly with respect to the indication, therapeutic aims, dose, efficacy, safety and cost.

Coordinate prescribing with other doctors involved in the patient’s care, and if possible, aim for one prescriber per patient. Ask if there is duplication of medications. Always start low, go slow, titrate and get there (optimal dose).

Doctors should also ask if the medication is intended to treat the side-effect of another medication. Consider also if they can simplify the drug regimen; are there potential drug interactions; is the patient adherent and is the patient taking OTC medications, herbal or traditional products, or another person’s medication?

On the other hand, it is the patients and their caregiver’s duty to be educated about their drugs and to inform their doctors of suspected side-effects of any drug. They should ask their doctor why each medication is prescribed and what it is intended to do. Effort must be made to understand when and how to take each medication (with food, on an empty stomach, before bedtime, etc.)

Patients should take their drugs exactly as directed. Find out what they should do if they miss a dose. Go to the same doctor all the time and take a list of all medications and their dosages along for review during each follow-up visit. Make sure labels on medications are read carefully and do flush away any medication that has expired.

Do contact the doctor immediately if there are any problems or side-effects with drugs. Don’t put different drugs in the same container as they do get mixed up and furthermore these drugs can interact with each other while in the container.

Do not stop or alter the way medications (time/dosage) are taken without talking to the doctor. Never share medication with someone else or take other’s medication without a doctor’s knowledge.

Conclusion

Polypharmacy remains an issue, especially for elderly people. Making an appreciable impact on the quality of patients’ lives with small interventions will always be one of the joys of working with older people.

Dr Yau Weng Keong is a consultant physician and geriatrician. This article is contributed by The Star Health & Ageing Panel, which comprises a group of panellists who are not just opinion leaders in their respective fields of medical expertise, but have wide experience in medical health education for the public.

The members of the panel include: Datuk Prof Dr Tan Hui Meng, consultant urologist; Dr Yap Piang Kian, consultant endocrinologist; Datuk Dr Azhari Rosman, consultant cardiologist; A/Prof Dr Philip Poi, consultant geriatrician; Dr Hew Fen Lee, consultant endocrinologist; Prof Dr Low Wah Yun, psychologist; Datuk Dr Nor Ashikin Mokhtar, consultant obstetrician and gynaecologist; Dr Lee Moon Keen, consultant neurologist; Dr Ting Hoon Chin, consultant dermatologist; Prof Khoo Ee Ming, primary care physician; Dr Ng Soo Chin, consultant haematologist. For more information, e-mail starhealth@thestar.com.my. The Star Health & Ageing Advisory Panel provides this information for educational and communication purposes only and it should not be construed as personal medical advice. Information published in this article is not intended to replace, supplant or augment a consultation with a health professional regarding the reader’s own medical care.

The Star Health & Ageing Advisory Panel disclaims any and all liability for injury or other damages that could result from use of the information obtained from this article.

What is a free radical?

The 10 most hazardous foods—and how to eat them healthfully

by Sally Wadyka for MSN Health & Fitness

Alfalfa Sprouts

Alfalfa Sprouts (© Corbis / SuperStock)

Alfalfa Sprouts

The danger: “Sprouts are at the top of the list when it comes to potential problems,” says Michael Doyle, Ph.D., director of the Center for Food Safety at the University of Georgia. “The conditions for producing sprouts promote the growth of harmful bacteria.” In order to grow sprouts, the seeds are soaked and kept moist—a prime breeding ground for bacteria (salmonella is the most common illness associated with sprouts).

The safer solution: While Doyle reports that some researchers are looking at ways to test the water in which sprouts are grown in order to identify batches that are contaminated, it is not yet a foolproof system, and recalls and illness outbreaks are still common. Growing sprouts yourself at home is also no guarantee of safety—the same conditions that breed bacteria in commercial sprouts can exist no matter how careful you are. Washing sprouts does not clean away harmful bacteria, so the only way to guarantee safety is to cook them. “Unfortunately, when you cook them, they pretty much disappear,” says Ruth Frechman, R.D., a spokesperson for the American Dietetic Association, who nonetheless mixes sprouts into cooked soups and stir-fries.

Eggs

Eggs (© Christoph Wilhelm/Nonstock/Jupiterimages)

The danger: The good news about eggs is that it’s the rare egg that will make you sick. “About one in every 10,000 eggs has salmonella,” says Frechman. “It’s a very low risk, but you never know when it’ll be your egg.” And since the infection can be laid inside the egg, the only way to eradicate it is to thoroughly cook your eggs.

The safer solution: Avoid raw eggs (like in cookie dough or Caesar salad dressing) as well as undercooked ones. Runny eggs are a potential danger zone—to be safe, you want to eat them well-cooked and solid. One option: look for eggs that are pasteurized in the shells. The pasteurization kills any bacteria that might be present so you can safely eat your eggs soft boiled or over easy.

Rare Burgers

Rare Burger (© Tetra Images/Corbis)

The danger: Eating raw or very rare beef is always a bit risky. Beef has the potential for carrying salmonella or E. coli contamination. And even when the meat is produced under the most ideal conditions, there is still a risk that it can harbor bacteria. The only way to fully guarantee that it is bacteria-free is to buy meat that has been irradiated. And ground beef is more risky than, say, a steak, because it is handled more, and after being ground it has greater surface area on which to harbor bacteria.

The safer solution: While a rare burger is defined as one cooked to 140 degrees or below, a burger has to be cooked to at least 160 degrees in order to kill any bacteria and be considered safe. At 160 degrees, a burger will look more brownish than pink in the center. But Frechman recommends using a meat thermometer to check your burgers before serving to ensure you’ve cooked them enough.

Packaged Greens

lettuce//(© Douglas Peebles/CORBIS)

The danger: Leafy greens—including cut lettuces and spinach—have been responsible for several outbreaks of disease and product recalls in recent years. One of the biggest scares was the 2006 E. coli outbreak that was eventually linked to bagged spinach that sickened 199 people and was responsible for three deaths. There are many ways that bacteria like E. coli or salmonella can infect produce—from infected animal feces that infiltrate the water or soil or from handling procedures during the picking or packaging. In most situations, washing the produce will not wash away the risk.

The safer solution: “Packaged greens are not more likely to carry contamination, but it is possible that you could have less likelihood of contamination if you properly prepare a head of lettuce than if you bought it pre-packaged,” says Doyle. He suggests that head lettuce, such as iceberg or romaine, is most likely to be contaminated on the outer leaves, so it’s possible to remove those outer leaves, wash your hands, cutting board and knife, then prepare the rest of it. In the case of leaf lettuce and spinach, it is all equally exposed to contamination, so there isn’t much you can do to minimize your risk.

Sushi

Sushi (© Renee Comet/FoodPix/Jupiterimages)

The danger: The primary cause for concern with sushi is the presence of parasites—tapeworms, flatworms and roundworms, for example—in the raw fish. To minimize risk, eat sashimi (sushi made with raw fish) at restaurants where the chefs not only know how to purchase the best fish, but also know how to identify and remove parasites during preparation. While no raw fish can be guaranteed safe, dipping it in soy sauce and wasabi may have a mildly antimicrobial effect.

The safer solution: Cooking fish to at least 145 degrees for a minute or more will kill any parasites residing in the fish. But then you no longer have sushi! The only way to eat it raw and still be sure it’s not harboring any parasites is to eat fish that has been frozen before it became sushi. The U.S. Food and Drug Administration recommends freezing fish to an internal temperate of -31 degrees for at least 15 hours in order to kill parasites.

Chicken

Chicken (© Ben Fink/FoodPix/Jupiterimages)

The danger: Raw chicken is a notorious carrier of salmonella and camplylobacter bacteria. It’s fairly easy not to serve chicken that’s contaminated—just make sure you cook it thoroughly with no pink showing when you cut it open (no one wants their chicken served rare anyway!). The biggest risk factors for getting sick is not from eating the chicken, but from cross-contamination during your prep and cooking.

The safer solution: Be careful when handling raw chicken. After cutting it up, immediately wash the knife, cutting board, the countertops and your hands to eliminate the risk of spreading the bacteria to other food in your kitchen. And when you bring the raw chicken outside to put it on the grill, take that plate back inside and get a new one on which to serve the cooked chicken.

Mayonnaise

Mayonnaise (© Pornchai Mittongtare /FoodPix/Jupiterimages)

The danger: Old wives’ tales aside, it appears that mayonnaise really isn’t all that risky. But because myths abound about food poisoning at family picnics caused by mayonnaise-laced salads, slaws and sandwiches, the condiment still made our list—if for no other reason than to debunk those myths. “The FDA standards for commercially prepared mayonnaise mean it has to have a certain pH and acidity that was developed based on studies to kill salmonella,” says Doyle. “So putting mayonnaise into a salad can actually have an anti-microbial effect.”

The safer solution: Homemade mayonnaise is still as risky as the mayonnaise myth would have you believe. So if you do make homemade mayonnaise, be sure to keep it—and anything made with it—refrigerated at all times.

Cantaloupe

Cantaloupe (© C Squared Studios/)

The danger: A recent recall of cantaloupe imported from Honduras because of salmonella contamination has focused attention on the melon. The rind that encases the fruit may harbor the bacteria, but it is easily transferred to the edible flesh inside once it’s cut up.

The safer solution: Doyle reports that some producers treat the exterior of melons with steam to kill the bacteria without affecting the inside of the fruit. But there’s no way to know if you are getting one of these treated melons. Washing the skin may help, but with so many cracks and crevices in the rind, it’s not necessarily an effective solution. You can be careful with the way cut-up cantaloupe is stored (at home or at the store). “Harmful bacteria can thrive and multiply at room temperature,” say Doyle, so he recommends steering clear of any cut fruit that isn’t kept refrigerated.

Unpasteurized Cheese

Milk & Cheeses (© Tetra Images/Corbis)

The danger: Unless you are getting your milk fresh from the cow, chances are it has been pasteurized—a heat treatment process designed to kill bacteria (including salmonella, listeria and E. coli) present in the milk. But even those who wouldn’t think of drinking unpasteurized milk may be unknowingly eating cheese made from that same untreated milk. Many soft cheeses—including brie, feta and goat cheese—are unpasteurized. Although federal regulation requires that domestic and imported unpasteurized cheeses be aged for at least 60 days, cheeses made from raw milk still carry some risk of contamination. Because of that risk, it is recommended that pregnant women, children, the elderly, and anyone else with a compromised immune system avoid eating them.

The safer solution: Steering clear of unpasteurized cheese is as easy as reading the label. “The ingredients will clearly list whether the cheese contains pasteurized or unpasteurized milk,” Frechman says. And while those unpasteurized versions can be delicious, just know that you are taking your chances.

Salad Bar Fixings

The danger: It may be the ultimate in convenience to swing by the salad bar and choose from a wide array of ingredients that are all chopped up and ready to mix into a customized meal. But letting someone else do all the prep work can result in some unhealthy surprises. “The biggest factors contributing to potentially unsafe salad bar food are foods that aren’t kept hot or cold enough, handling of food by workers with poor hygiene, and refilling partially used containers of perishable food with fresh food,” says Doyle.

The safer solution: Be sure your salad bar food is kept at the proper temps (cold food kept cold, hot ones heated sufficiently), that workers practice safe food handling, and that enough people buy food there to keep the supplies fresh. Also, Frechman cautions against salad bars that don’t have a “sneeze guard” to protect the food from airborne bacteria.

Referenced from: http://health.msn.com/nutrition/slideshow.aspx?cp-documentid=100200169&imageindex=1

10 Foods That May Improve Your Appearance

By Laurie Pawlik-Kienlen for MSN Health & Fitness

1. Blood oranges, cherries, and blueberries

Blood orange//© Anthony-Masterson/StockFood Creative/Getty Images

Collagen is a natural protein in your skin and muscles that provides resiliency, shape and texture. Unfortunately, collagen production decreases with age— but you can fight back with dark fruit. "Blood oranges, cherries and blueberries are full of antioxidants, which decrease aging and disease by lowering inflammation. Antioxidants also increase collagen production and thicken the skin, making you look younger and healthier," says Julia Tatum Hunter, M.D., of Skin Fitness Plus in Beverly Hills. "Antioxidants also decrease [the severity of] rosacea." Blackberries, raspberries, plums, pomegranates, cranberries, Asian dragon fruit and kiwis also contain antioxidants.

2. Shellfish, sunflower seeds & sardines

Sunflower seeds//© Lew Robertson/FoodPix/Jupiterimages

These foods may not taste great together, but individually they offer a powerhouse of essential fatty acids. Steven Chang, M.D., staff physician for RightHealth.com, says fatty acids nourish the skin, help maintain skin integrity and keep skin cells performing optimally. "Essential fatty acids, a component of all cell membranes in the body, regulate the flow of nutrients, waste materials, and water in and out of cells—which keeps you looking young." Flax seeds, tuna, walnuts, canola oil, soybean oil, and pumpkin seeds are more good sources of essential fatty acids.

3. Dandelion, turnip & mustard greens

Mustard greens//© Lisa Hubbard/FoodPix/Jupiterimages

"Foods that keep our livers cleansed of toxins, heavy metals and fats make our whole body function more efficiently," says Dr. Hunter. "This makes us happier, which affects how we look. Plus, a healthy liver brightens our eyes and tightens our skin." She recommends dense green foods such as broccoli, spinach, and arugula—as well as turnip, mustard and dandelion greens. Eating these slightly bitter greens has been shown to lessen your sweet tooth. Hunter warns: "Simple and refined sugars, high-glycemic carbohydrates, and refined, manufactured foods age us." Excess sugar has been linked to a process called glycation, in which sugar molecules bond to protein molecules, which has been linked to sagging, wrinkled skin.

4. Oregano, thyme and parsley

Parsley//© Image Source Black/Jupiterimages

"If you have puffy bags under your eyes in the morning, you are almost certainly consuming much more salt than you need," says Doris Day, M.D., author of "Forget the Facelift: Turn Back the Clock with a Revolutionary Program for Ageless Skin." "Another problem is alcohol: It dehydrates you and can make your skin sag. The worst combination is alcohol and salt, which causes puffy dark circles under your eyes." Dr. Day recommends reducing your sodium intake to eliminate bloating. Instead of salt, season your meals with herbs and spices such as oregano, thyme, rosemary, parsley and garlic.

5. Crunchy vegetables

String beans//© Ann Stratton/FoodPix/Jupiterimages

Fresh raw veggies are as good for your grin as they are for your skin! Celery, carrots, string beans and cauliflower contain cellulose, which helps scrub stains from your teeth—giving you a whiter, brighter smile. "Both the cellulose and the [other] fiber in these foods act as abrasives that clean and remove bacteria from teeth," says Mickey Bernstein, M.D., president of the American Academy of Cosmetic Dentistry. Crunchy veggies are especially effective for recent discolorations. If you've just consumed blueberries, coffee, mustard, red wine or cranberry juice, follow it up with fresh cucumber slices or an apple.

6. Sea vegetables

Hijiki seaweed//© Steven Mark Needham/FoodPix/Jupiterimages

"Polluted cells can't function at their optimum level. When our cells are functioning optimally, not only do we have more energy—we look and feel great," says nutritionist Carol Wasserman. "Sea vegetables are one of our richest sources of minerals and phytochemicals." These veggies help detoxify, rebuild and nourish all the cells in our body. Unhealthy foods, stress and environmental pollutants cause cells to age prematurely, potentially leading to thinning hair and premature wrinkles. "Sea vegetables reverse this process," says Wasserman. "For example, spiruluna is a 'detox powerhouse.' Hijiki, kelp, arame, wakame, and dulse also work wonders."

7. Meat, cheese and lentils

Lentils // © Photos.com/Jupiterimages

It may take 10 pounds of milk to make a pound of cheese, but fortunately you don't need to eat that much dairy or protein to repair your cells. As you age, your hair and skin cells become damaged, making you appear older. The protein in meat, chicken, low-fat cheese, cottage cheese, and certain vegetables promotes cell growth and repair, which translates to younger-looking skin, fewer wrinkles, less hair loss and a glossy mane. To take a break from meat or dairy, try soybeans and lentils instead (they contain more protein than any other legume).

8. Egg yolks, organ meats and whole-milk products

Hard-boiled egg // © TOPIC PHOTO AGENCY/age fotostock

Dr. Chang says, "Vitamin A is especially important for skin repair, and decreased levels can lead to dry, flaky skin." Dr. Day adds that a lack of vitamin A may cause your skin to heal poorly and wrinkle easily. The main sources of this vitamin are foods from animals, such as liver, eggs and whole-milk dairy products. Some plants—carrots and broccoli, for example—supply beta-carotene, which your body converts to vitamin A as needed. Apricots, nectarines, plums and cantaloupe are more great sources of beta-carotene.

9. Almond or hemp "milk"

Hemp milk and seeds // © Jeff Kauck/FoodPix/Jupiterimages

Almond milk is a nutritious dairy alternative because of its high levels of magnesium, potassium, manganese, copper, vitamin E, selenium and calcium. Licensed medical esthetician Tina Seitz says, "Hemp milk is a delicious, nutty-tasting non-dairy beverage that provides essential balanced nutrition. It's a fantastic alternative to soymilk or dairy, and has a natural well-balanced ratio of omega-3 and omega-6 essential fatty acids to keep your mind sharp, your immune system strong and your skin glowing." Both almond and hemp milks are plant-based, and don't contain lactose. They offer high-quality protein that can give hair a radiant, healthy shine and helps keep skin soft.

10. Wild salmon with avocado and mango dressing

Salmon and avocado // © Jackson Vereen/FoodPix/Jupiterimages

This is more than a delicious meal—it's an anti-aging feast! Stephen Sinatra, M.D., of the University of Connecticut School of Medicine says, "Wild Alaskan salmon has precious omega-3 essential fatty acids, which enhance blood flow. The pink/orange color of wild salmon is an anti-aging carotenoid called astaxanthin that protects cell membranes." Salmon also contains dimethylaminoethanol (DMAE), which improves facial muscle tone and reduces wrinkles. Add avocado for its antioxidant properties and mango (for vitamin E and anti-inflammatory carotenoids) and you'll be sitting pretty after dinner!

Difference Between Man and Woman

VERY true... at least for me ;P

My first foray into mountain biking

I ventured into this sport half a year ago - March 2008 to be exact. Tried out this sport on a borrowed scandium bike from a friend for a few rides before I decided to get a bike of my own. My first bike is an Ellsworth Id which I bought second hand from a mountain biker in Muar. It has pretty good specs - XT groupset, Romic suspension andFox Vanilla fork. Well, hopefully that will keep me from upgrading my bike for a few months.



Looking back, I think this quite a hardy bike. Crashed a couple a times week in and week out due to my over eagerness to push the bike and myself to the limit. The bike has thus far came out of all my crashes unscathed. I later found out this bike was actually a XC oriented freeride bike. I have no idea what is freeride when I first bought this bike but later found out that freeriding involves some very aggressive riding - bombing downhill, jumping over obstacles, blasting downhill at full speeds and bikes built for this genre of mountain biking are usually very durable and are a tad heavier than XC oriented bikes - which explains why I have the heaviest bike in my cycling group. A hardy bike is what I need actually - I might have broken or cracked any light XC bike by now judging from the number of "dramatic" crashes that I have gone through. Oh well, what doesn't kills you makes you stronger!




To date, mountain biking has been a weekly ritual to me if I'm not out of the island. I have thoroughly enjoyed the fellowship and the journey back to the heart of nature that comes with each ride. It is something that I look forward to every weekend and it is somewhat a short weekly vacation for me to relax ad unwind. I have seen more of Penang in the past 6 months than the past 5 years I have staying here. I have tasted many new foods and met many people in all the trails that I have been to. Moutain bikers are a bunch friendly lot. I have never fail to be greeted by mountain bikers everytime I pass one at the trails. Something tells me I'll be in this sport for a long, long while...

Power of Love

Fresh lemon grass tea kills cancer cells

If you are a cancer patient in Israel, your doctor is telling you to drink fresh lemon grass tea on the days that you go in for radiation or chemotherapy treatments. Ben Gurion University of the Negev researchers made a discovery last year that the lemon aroma in herbs like lemon grass kills cancer cells in vitro, while leaving healthy cells unharmed. In a fascinating article published in the Health section of Israel21c, it states that the study found the citral in lemon grass causes cancer cells to commit suicide in a process called apoptosis, a mechanism called programmed cell death. A drink with as little as one gram of lemon grass contains enough citral to signal the cancer cells to commit suicide.


Lemon grass is a perennial, aromatic tall grass with a light lemon scent used for culinary and medicinal purposes. For centuries, herbalists have used the herb as an effective digestive tonic and nervous system relaxant. Lemon grass oil is used to help clear blemishes and maintain balanced skin tone. Lemon grass is also used as an insect and mosquito repellent. Now, according to Israeli scientists, they can add cancer prevention to the list of attributes associated with lemon grass.


Referenced from: http://www.thecancerblog.com/2006/04/02/fresh-lemon-grass-tea-kills-cancer-cells/

Note: The contents of this blog are for informational purposes only and should not be construed as medical advice or substitute for professional care. For medical emergencies, dial 911!

Lang Tengah - June 16th - 18th,2006

Lang Tengah (16th-18th June 2006)

Drove from Penang Island at 5am in the morning. A convoy of 2 cars - Sunny, SC, Chiew, Chiang Mei, Poh Ye, and Raymond in the Unser and Phai Lin, May and I in the Waja. Departed at different times but we met up somewhere at Jertih at around 9am. The drive up to Jertih was interesting and challenging - misty winding roads. Saw a pair of mother and child elephant somewhere at the border of Kelantan. We arrived at the Mahrang Jetty at around 10am. Met up with Elisabeth and Steven there. Parked our cars at the jetty. We are charged RM5 per day for parking there.. a bit of a ripoff but wutudu..

It's nice to be out in the sun again.

Day 1

On the ferry to Lang Tengah

Poh Ye, Chew and Chiang Mei - Happie nyer...

A-OK..We are good to go!


Elisabeth and Phai Lin - All smiles


On arrival at Redang Lang Resort

Arrived at Redang Lang Resort at around 11am. Paradise once more. Clear waters and fine sand sands.

View of the Redang Lang Resort from the ferry

"There was a time when sex was safe and diving is dangerous"..since when?

First Dive

Checked in to our recpective rooms and had lunch soon after.

Day 2