Back for good.

Its been a while since I posted something here. I have been busy with transfering, from Kuching Sarawak, back to mainland, Subang Jaya. A place I call home. I spend almost RM4000 for my transfer, with my car shipping being the most super expensive. But to be honest, I havent felt like Subang is my home for the past few years. Eventhough family and friends are all here. I feel like i have no place i call home. Hmm.

I've only been home for a week, and this weekend i'll be moving to Kuantan. I'll start my new job as a lecturer trainee under IIUM in the oral surgery department next Monday. To be honest with you, im nervous. Especially the part where I have to wear a hijab to work. Im not used to it, plus I dont like the fact that it hides my elegance from my hair. But i believe that this is one step towards a rightful pathway back to Allah Almighty, and a successful one. Ive been blessed with oppurtunity and hidayah and I am accepting it with an open heart and will try my best to work hard for my excellence. InsyaAllah.

Guess now im back to searching for an apartment to rent at Kuantan for now. What. A. Life.

Beware of Guns.

Ever since I moved and start living in Betong, I have been actively reading articles online regarding dentistry and anything that has to do with it, which is surprisingly good since I have always pushed myself for so many times to be constantly updated with the latest knowledge and development in dentistry.

So recently, as I was browsing through Google to find an article about painless dental visit, I stumbled upon an article, a published letter to the Editor of The Star on February 2008 regarding dental visits in Malaysia. So here is how the letter goes;

Dental visits a pain in the pocket

ACCORDING to statistics, about 10% of people who are 55 years and older will begin to lose their teeth. Whatever the cause attributed to each individual, age is the single biggest factor. Because of our ageing population, the number of people who would become edentulous would be a substantial number. The market is huge.

Many old folks are at the mercy of dental surgeons, especially the ones who now describe themselves as implantologists. Many of them wear doctor’s coats, carry stethoscopes and insist on being called doctors.

They charge by the tooth for every implant. Current prices range from RM7,000 to RM9,000 for the implantation of a tooth. This does not include the cost of the replacement parts, surgery, X-rays, etc. Hence, for about four to five teeth to be implanted in the average elderly person, the price can come up to RM45,000. This is more than the cost of a complex angioplasty, bypass operation, or a hip replacement.

There seems to be no regulation to control these prices. It is a free market, with dentists, specialists, as well as GPs competing and charging whatever the market can take. Most older people are poor and have to depend on their relatives. And few family members want to pay these exorbitant charges.

Government specialists, curiously, do not provide teeth implants for most of these unfortunate victims. If they do, it is to learn the technique before leaving government service. While the cost of private medical care is now regulated and there are guidelines provided by the MMA, implantology is a wide open field with no control. Even the Malaysian Dental council has not tried to exert any control. The patients who cannot afford implants are given cheap dentures or a mix of implant and a bridge (if they can afford the latter).

Having watched the implantation procedure, I think this is really a simple procedure, most of the time done under direct vision. There are no special tools required. Most surgically trained medical GPs should be able to learn this procedure very quickly. There will, of course, be some difficult cases which can be left to the specialists.

Dental surgeons, whether specialists or GPs, work in a very narrow field of the human body. From experience, I have learnt that they know little or nothing about the wider spectrum of medicine. The number of antibiotics they are familiar with is very few. They ask for a history of diseases that the patient may have but do not know how to assess how bad these diseases are or how they should be treated. They have no idea about emergencies that may occur with surgery or with drugs. They do not know anything about cardiopulmonary resuscitation.

Because of these weaknesses, I would suggest the following remedial actions:

> The Malaysian Dental Council should investigate and control prices in this dog-eat-dog business. They must impose some discipline to care for poor old people.

> The dental surgeon who calls himself an implantologist should give a written bill to the patient before he starts treatment. He should list all his immediate charges as well as charges for subsequent visits.

> It should be possible to train technicians to do single implants. These technicians should be licensed and also given guidelines on charges. Prices would come down in a free market once you increase the supply.

> Medical emergencies during a dental implant are rare but can happen. Hence it should be mandated that an anaesthetist should be on standby during any implant or surgical procedure done by a dentist.

> The dentist should buy and place in his clinic emergency equipment. This would include a defibrillator, a heart monitor, a pulse oxymetre and an ECG machine.

> The implantologist should be certified, which means going before a panel of peers who will verify if he has the knowledge and skills to perform large volume implantation.

MEDICAL DOCTOR,
Kuala Lumpur.

My first few words that came out after reading this was: Shame on you medical doctor! Obviously he knows nothing what a dentist can do. Clearly he knows nothing about general health. I was to a certain extent angry initially. But I seek to understand and acknowledge his needs to be emotional about the costly dental treatments. If I could write a personal letter back to this medical doctor, I would not explain or educate him a single thing about dentistry. With his appalling judgment about dentists, it is such a disgrace to have a colleague in the health sector with an attitude and mindset like this. I don’t intend on being emotional and biased. So, to other medical doctors out there, to friends, and colleagues, here is my respond on this atrocious accusation.

First and foremost, I would like readers to know that I have made a meticulous exploration on the latest development, guidelines and knowledge on topic above mentioned prior to making my comments and response.

It is true that edentulous people are becoming a substantial number. According to NOHSA 2000, more than one third of population in 65-74 years of age was edentulous; almost half of population was edentulous by the age of 75. From that, more than ¼ of population wore prostheses, removable or fixed, or both. Female population was in higher proportion than male, and the urban and rural population was equally same. With that being said, there is no need for discrimination of pooper population having no better teeth replacement, such as implants. People pay for what they can afford regardless of how they want the otherwise. That is just how life is. No poor people who work manual labor obtaining 50cents per hour dream of ever owning a brand new Honda City. While on the other hand, a medical doctor is able to afford that. Even though it is likely that they want a more luxurious sporty BMW M3 series instead. Point is, change only what you can, accept what you can’t!

In his emotional letter, he accused that dentists insist on being called doctors and wear doctor’s coats carrying stethoscopes and that we know little or nothing about the wider spectrum of medicine. Doctors make people healthier. When people get sick, or in pain, doctors figure out why, do tests to see what is wrong, and give them medicine and other kinds of treatment. Dentists are equally doctors; doctors of dental medicine, specializing in the region of head and neck. During undergrad, we were taught of all basic medical sciences, from anatomy to physiology, pharmacology and more. There is a need for dentists to know all that because the mouth has a connection to the guts through the esophagus, and to the lungs through the trachea. Whatever that is in the oral cavity has the likelihood of transferring to the whole gastrointestinal system. And subconsciously, people are at risk of inhaling bacteria into their lungs and that can bring to diseases if the bad things pass through. The neck connects the head to the body. Blood vessels in the head and neck drains directly to the heart. No dental patients coming in to dental clinic leaving their body and limbs at the medical clinic. Isn’t that common sense already? One a medical doctor should have known.

In addition, dentists are at a closer contact with patients because commonly, dentists treat diseases in their mouth, a very narrow part of the human body but the number one home of bacteria. Dentists wore white coats to protect themselves from this infectious air spray during treatment. With regards to carrying stethoscopes, dentists, usually those oral surgery specialists, they are usually involved in surgeries in the OTs, repairing clefts, fixing fractured facial skeleton, marsupalizing large cysts, sectioning bony tumors and reconstructing the face. And all these surgeries usually require an anesthetist and long hours in the OTs. It is the surgeon’s responsibility to ensure that the patient’s vital status is in good stable condition, hence the need to carry the stethoscopes. One is considered malpractice if did not ensure stable vital status. One is not proudly carrying stethoscope for the sake of respect.

With regards to implants, this particular treatment modality is well known to be expensive, not because a private general dentist blindly charges patients. The Malaysian Dental Council together with the Health Ministry have set the range of dental charges for basic dental treatment under the Private Healthcare Facilities and Services Act.  It is the nature of implantology itself. This treatment of replacing lost tooth is a new development founded early 20^th century but first successful implant dated end of the 1970s. Implants are expensive because of its technique sensitive to create a biological integration between metal and bone. Plus, titanium is the only metal that can produce integration between bone and implant. Therefore, the type of metal itself is already super expensive. Even then, the cost for dental implants in Malaysia is one of the lowest in Asean.

Implants in the government service are available but limited to specialists only. Even then, these treatments are still as expensive as private clinics. “Medical doctor” also stated that the implantation procedure is an easy procedure done under direct vision. Yes, looking at it in youtube looks easy. Something even a technician can do. Seeing is easier than done. Please Wikipedia this: dental technician. They are a member of the dental team who upon prescription from a dental clinician constructs custom made restorative and dental appliances in the lab. Work of place: lab. They do not have direct communication nor deals directly with patients. They deal with dental materials in the lab, constructing prosthesis. They are not trained to treat diseases in the mouth. Implants are not simply done by GPs. A certificate of Implantology is required for the practice. There are many factors to be considered in implants, the art and science of it. An oral surgeon has to undergo lengthy clinical and hands-on training to become an expert in the field. There are existing ethical bodies to regulate this practice and dentist’s competency.

With that being said, I feel the writer was wrong in all his statements and figures. He was too emotional in expressing his opinion and created an increase in dental phobia among dental patients. One important phenomenon that everyone must realize is that: “What a dentist can do only a dentist can do.”

Terms and conditions of trust.

I live and work in Betong. But life for me was never there. Despite trying to save teeth (which the community here so much refuses) and ensuring people's general health, my presence in Betong does not really mean much. Every weekend i would drive 3 and a half hours down to Kuching just to relax, enjoy the lights and sounds of noise for awhile, and be happy. In other direct words, i would drive 3 hours down to the city just to see someone i love. Yes, love! I certainly do not dare to say this 4 letter word but i did. I love, again. And to be honest, I'm not slightly scared about it. Because I'm happy. Truly happy. And I feel safe, even when we are distant. I feel like i can trust again, and i did. But is that the right thing to do? 

Chocolate and Mint

I read one's blog about tips on increasing followers to your blog. And among others, one of the tips mentioned was to Put a lot of pictures.

Honest opinion, I dont think putting a lot of pictures in your blog is even a right way of blogging. To start with, correct me if I'm wrong, blogging is about expressing thoughts, opinions and comments... with words! Yes, the internet business nowadays focuses on various ways of expressing yourself, your thoughts, opinions, skills, etc. And you have the rights to do it in your convenience. Blogging is one of them of course. Facebooking, tweeting, youtubing, flickring, tumblring, deviantart, are of the many.

I have always believed that blogging is about playing around with words. Blogging is about expressing your inner self with words literally. Of course, there is an option of inserting images in your blog post but that is only optional and used only when required.

Somehow, that isn't the case. Recently, i bloghopped a lot, and i came across malaysian bloggers who maximizes pictures in their blogs especially photos of their annoyingly beautiful and flawless faces. I won't be a hypocrite and pretend that i'm not jealous of their beauty at all. There is slight jealousy in me despite the fact. But they aren't just plain bloggers. They're famous bloggers whom if i am not mistaken are also public figures and role models to most. This is just an upsetting way of depicting what blogging is all about.

Many more things can be said but my mind is just all around and i can't seem to be focusing. But then again, it's up to you how you want to convey them to the public.

Blegh. I think this is just irrelevant, useless and lame. This post is irrelevant, producing no solution in the end. Useless. And lame. Sampah, if one should call it. And this, i recall to Redza's latest movie review. Check it out. A totally blog-aggressive argument went down there  :)

And if you really wanna go there, here's one photo for all of you to ponder on the things that i have just typed out in less than 5 minutes.

Seriously? Female anatomy? 

Lets pray for Hidayah

"The Prophet's mind and heart had indeed been expanded and purified: the burden which pressed on his soul had been removed; and his name exalted in this world and the next. For the righteous man there is no trouble. But is linked with ease and joy; he must strive at every stage, and look to Allah alone as the goal of all his hopes." - Surah Al-Inshirah commentary by Abdullah Yusuf Ali

I begin this post with a verse adapted from the Holy Quran. For the past few weeks, for the past few months to be frank, i have not been in a very good place of mind and heart. I think too much. Mostly about my future and about my career in dentistry. I have been staring at this blank post for more than half a day and I was speechless, thoughtless, typeless. I came back from the clinic, continue staring at this blank post for another half an hour when i realized that I have so much to do at home. But my mind just couldn't tell my body to get up and get going. Instead, i lay down on my bed and just stare at the blank white ceiling, thinking, but nothing came up. I didnt have a clue how I came to this. What has been bothering me lately? Ever since I moved to this small town, I have been alone. I stayed at home alone. At work, although i have same level colleagues, but I just do things on my own. I dont talk to them that much. What happened to me? I kinda became anti-social. I rarely laugh nowadays you know. Sigh.

 

I was invited by the dean of Dental Faculty IIUM in Kuantan Health Campus to join their service as a lecturer (trainee) in the department of Oral Surgery. Though it sounds exclusive, interesting and challenging, but I have always wanted to return home, in Subang Jaya. And yesterday, I was given the news that my application to UiTM as a lecturer trainee was successful. Unfortunately for me, they're putting me in the paediatric dentistry department. When i went to the interview, I managed to show and persuade them how much I love Orthodontics but unluckily for me, the department was fully occupied and they're placing me in a different one instead. Now, I am in the verge of making a decision of my life. My whole life, my whole future, my whole career depends on how i decide NOW. How shall i say this.. its just crazy for me. I feel like i'm carrying the burden of my whole unpredictable future. 

Lets just pray for guidance from Allah subhanawataala for a prosperous successful future. InsyaAllah.

I start blogging again. InsyaAllah.

As the title of blog implies, this is Izzy Ismail first time blogging in thisisizzy blogspot. Full name, izzati nabilah ismail born and raised in Subang Jaya, until i continue my studies in kelantan doing dentistry in usm and now i am proud to be a 100% qualified, paid, scraping, decay fighting anesthesizing, teeth saving dentist in Sarawak, previously in a lovely peaceful city, kuching, and currently, small district cowboy town, betong.

I used to be an active blogger at livejournal a while ago. But it went on hiatus for so long due to busy schedule and lack of things to say. Previously i blogged like a mad person, saying things no one would understand except myself. And i started noticing no one ever reads my blog, hence the quit. I wouldn't dare say myself that i'm a quitter but this is no ordinary quitting. This is just a case where i just went on hiatus for quite a long time.

By the way, did you know people, and i mean common people love to read common blogs about one's daily activities. I find it pretty lame at first until i started doing it recently. I became one of the people who read blogs that gave me no inspiration, no motivation. Simply just useless blogs, i dare say. Some of the blogs i routinely visit are Vivy, Maria, KeikoLynn, and Adriana. Besides their passion towards beautiful and funny things, i have no other common interests, neither do i have anything to do with these beautiful bloggers. They are just some famous bloggers that i found while bloghoping at Vivy's about a year ago and unexpectedly bookmarked them. I now routinely read and check their blogs because I am trying to find something just less meaningful besides my responsibility to the community as a dentist to help myself pass through my long lonely boring hours of stay in Betong. I will soon blog about how it really is over here in this small town. Other blogs that I am head over heels in love with includes, Alfactor, Redza Minhat (the famous Faqir in the Malaysia's Picau Cukur), Hyperbole and last and of course not the least, Dishie, my lovely sister.

Well, my new and improved blogspot is now up and running (sounds like running a business). I came back to the blogging business through a strong influence and motivation by a very good friend of mine. I hope it stays with me through out my life. So that once in a while, I could take a moment and reminisce the significant moments in my life that is blogworthy enough.

PS. This is just a note to myself.