Prevention Of Heart Diseases
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Porto Romano @ Taman Tun
Someone told me that this is a great place for pasta which at Taman Tun vicinity. I thought of trying out this place if I pass by Taman Tun
http://porto-romano.com/
Porto Romano
28, Persiaran Zaaba
Taman Tun Dr Ismail
Kuala Lumpur
Tel No: 03 – 7710 0509
(Pork Free. Open from 11.00 am to 11.00 pm daily. This is at the same row as Canadian Pizza, Homst, Santai and is directly behind La Manila Cafe.)
http://porto-romano.com/
Porto Romano
28, Persiaran Zaaba
Taman Tun Dr Ismail
Kuala Lumpur
Tel No: 03 – 7710 0509
(Pork Free. Open from 11.00 am to 11.00 pm daily. This is at the same row as Canadian Pizza, Homst, Santai and is directly behind La Manila Cafe.)
The Elegant Sphisticated Women
Sophisticated Confidence You'll feel more beautiful when you learn how to have confidence.It has been said that confidence is next to beauty that causes a woman to be appealing.Confidence means you know how to act in any situation, making you sure of what you are doing. How do we get confident in _______ (fill in the blanks)?Playing tennis Being comfortable on a first date Speaking French Dressing up Doing your hair Being financially free Here is the secret:Confidence only comes when you've done something over and over enough times and made enough mistakes that you finally learn how to do it right. Then you do it automatically and you don't have to think about it anymore -- that's confidence. So whatever you find in your hands to do, practice, practice, practice. Keep at it no matter how frustrated you are. google_protectAndRun("ads_core.google_render_ad", google_handleError, google_render_ad);The Elegant Sophisticated Woman How to "Fake" Confidence If you don't feel confident (yet),Practice Your Perfect Posture Pay Attention To Your Grooming Practice Eye ContactYour posture tells the world how to treat you from sight alone. You can either look like winner or a loser. Posture is the single most important body language there is. Erectness is confident-looking. People will believe what your posture tells them about you. For instance, if you tell a little boy to "act like a King", instantly you'll see him straighten his back and his neck as though he were wearing a crown. You wonder who teaches them these things! http://www.flickr.com/photos/bitchbuzz/ / CC BY 2.0Your posture communicates..Psychologists say that the first indications that a person's morale is dropping when her daily grooming habits slip. Haven't we all seen girlfriends who have had their hearts broken not bothering with make up anymore, letting themselves put on weight and the such? We've all watched television shows which depict people in real life who have been told they've lost all their money? The most educated groomed men starts to resemble the beggar on the street.Eye contact is another indicator of confidence. Practice looking people directly in the eye as it will help you establish a position of confidence in the minds of others. Do not stare at their eyes or gaze into them. Look at their eyes when speaking, but be natural. If you are opening your eyes more than normal, you are gazing!google_protectAndRun("ads_core.google_render_ad", google_handleError, google_render_ad);The Elegant Sophisticated Woman How To Be Sophisticatedly Interesting http://www.flickr.com/photos/flapessoa/ / CC BY 2.0An interesting person is an person who is interested.Do not worry about being interesting or TRY to be interesting.Tastefully engage in conversation with others, learn about someone else's culture.Have avid social life. Take part in charities, serve in church, throw dinner parties.Take an interest in yourself, always seek to grow, refine your knowledge, get better at things. Embrace change. Learn about things that increases your sophistication like(Pick 2-3)Art - drawing, painting, or Art in museums Literature/History Languages & Cultures Theatre, Plays, Musicals Dance - the Ballet, Waltz etc Music - Symphonies, Musicals Sports - Skiing, Tennis, Golf Water sports - Sailing, Speedboating Travel
Wardrobe Careful Planning
Wanted to read through some tips on have a good planning of wardrobe and manage to get this helpful information fromt he web.
Wardrobe Careful Planning
Planning is essential to an elegant woman's wardrobe. An edit should also be done every three months.
The best dressed women are often those who devote the most thought which does not mean the most time, or the most money on their clothes.
Whenever there is a change in seasons, or when there is a change in lifestyle (a baby, a new job etc) it is a good idea to make an inventory of your wardrobe to prepare for the new period.
First, take an inventory of your wardrobe
You must be perfectly objective and ruthlessly discard, or make repairs to:
- blouses whose collars have weaken - faded or spotty clothes - worn/stained materials - outdated garments - worn out shoes/handbags that you have been saving for a rainy day - hats, accessories that have gone out of style
Give away anything that you haven't worn for the past six months, unless they are of those types that are worn only in a particular weather or season.
Acquire Your Basics
Next, ensure that you have your basics otherwise, they should be the first to be acquired.
At any point in time, you should have already acquired your basic clothes. These are everyday clothes that can be worn like a uniform and throughout the seasons.
Your basics depends on your lifestyle. For some, it is a pair of skinny jeans and light cotton shirts, others they are mid length skirts that go with a variety of blouses. Little sleeveless cotton dresses are good choices too.
If you are unsure how to do that, first make a list of the different activities in your day-to-day. Feel free to write a description of the major activities.
For instance:- Cooking- Cleaning- Running errands (what type of errands and where)- School- Work- Meeting friends for coffee- Walking etc etc
Analyze your wardrobe
Next analyze your inventory and be wary of the areas where you have too much of something (e.g. stilettos when you only wear them once a week for cocktails) and too little of everything else.
You may do this by categorizing your clothes the best you can. It will never be perfect because you can use an item for many other categories but the purpose of this exercise is to know what you have.
E.g. Career Daytime clothes Evening Sportswear Housedress Negligees
Separate your clothes, shoes, bags and accessories as much as you can and those that you can't seem to categorize because they can be used for everything, set a category for them under "Uniform - everyday stuff or a category "special use".
For example, in my wardrobe, under "Career", I don't have any business suits because I don't work in a corporation. I don't own any black leather business cases. I usually work from home or in cafes, and once in a while I go my shop so my "Housedress" and "Daytime clothes" are more important.
Try to think ahead also of any special trips you may be planning as well as special events like weddings or balls that may be on your social calendar
Matchmaking
Because coordination is essential to elegance, celebrity fashion stylists like Rachel Zoe have emerged and made quite a living simply by facilitating this. They provide their clients with various sets of matching accessories and even complete coordinated wardrobes.
As Madame Genevieve Antoine Dariaux observes, "Their efforts are certainly praiseworthy and have contributed a great deal to improving the aspect of our city street scene. But as in every other phases of elegance, moderation is always the best policy."
Practice restraint
I think she means like for example if you adore Burberry's signature checkered prints, you must not let yourself be carried away by the delight of wearing everything Burberry's.
Try to do more with less. A single piece of statement jewelry, or simple silver pearl earrings...your restraint will be rewarded by increased elegance.
Pick solid colours
If you only could have five new articles of clothing for the whole year, pick clothes of solid colours.
Solid colours can stand repetition much better than patterned materials. Also, again, if you could only have five pieces in your entire wardrobe, I suggest you pick basic or earthy colours such as black, white, ivory, beige, champagne, navy.
Next to build from your wardrobe is to invest into a few pastel-coloured pieces which will add a fresh touch to daytime wear.
With solid colours, you can dress it in different ways by accessorizing. A day time outfit can transform to evening wear by simply removing a scarf and wearing a long strand of pearls.
Avoid being too "matchy, matchy". It may look too 'costume' for anyone to take seriously. Gone were the days where the shoes were made of the same fabric as the bag, the sash and the ribbon on the bonnet.
Although it is advised to exercise restraint in match making, there are somethings to be matched and doing so is very elegant.
For instance, matching the umbrella to your outfit/coat, your various luggage pieces and toiletry bag, your wallet, purse or bag, your lingerie set, the outfit to the occasion.
Your own good taste is probably the best judge.
Wardrobe Careful Planning
Planning is essential to an elegant woman's wardrobe. An edit should also be done every three months.
The best dressed women are often those who devote the most thought which does not mean the most time, or the most money on their clothes.
Whenever there is a change in seasons, or when there is a change in lifestyle (a baby, a new job etc) it is a good idea to make an inventory of your wardrobe to prepare for the new period.
First, take an inventory of your wardrobe
You must be perfectly objective and ruthlessly discard, or make repairs to:
- blouses whose collars have weaken - faded or spotty clothes - worn/stained materials - outdated garments - worn out shoes/handbags that you have been saving for a rainy day - hats, accessories that have gone out of style
Give away anything that you haven't worn for the past six months, unless they are of those types that are worn only in a particular weather or season.
Acquire Your Basics
Next, ensure that you have your basics otherwise, they should be the first to be acquired.
At any point in time, you should have already acquired your basic clothes. These are everyday clothes that can be worn like a uniform and throughout the seasons.
Your basics depends on your lifestyle. For some, it is a pair of skinny jeans and light cotton shirts, others they are mid length skirts that go with a variety of blouses. Little sleeveless cotton dresses are good choices too.
If you are unsure how to do that, first make a list of the different activities in your day-to-day. Feel free to write a description of the major activities.
For instance:- Cooking- Cleaning- Running errands (what type of errands and where)- School- Work- Meeting friends for coffee- Walking etc etc
Analyze your wardrobe
Next analyze your inventory and be wary of the areas where you have too much of something (e.g. stilettos when you only wear them once a week for cocktails) and too little of everything else.
You may do this by categorizing your clothes the best you can. It will never be perfect because you can use an item for many other categories but the purpose of this exercise is to know what you have.
E.g. Career Daytime clothes Evening Sportswear Housedress Negligees
Separate your clothes, shoes, bags and accessories as much as you can and those that you can't seem to categorize because they can be used for everything, set a category for them under "Uniform - everyday stuff or a category "special use".
For example, in my wardrobe, under "Career", I don't have any business suits because I don't work in a corporation. I don't own any black leather business cases. I usually work from home or in cafes, and once in a while I go my shop so my "Housedress" and "Daytime clothes" are more important.
Try to think ahead also of any special trips you may be planning as well as special events like weddings or balls that may be on your social calendar
Matchmaking
Because coordination is essential to elegance, celebrity fashion stylists like Rachel Zoe have emerged and made quite a living simply by facilitating this. They provide their clients with various sets of matching accessories and even complete coordinated wardrobes.
As Madame Genevieve Antoine Dariaux observes, "Their efforts are certainly praiseworthy and have contributed a great deal to improving the aspect of our city street scene. But as in every other phases of elegance, moderation is always the best policy."
Practice restraint
I think she means like for example if you adore Burberry's signature checkered prints, you must not let yourself be carried away by the delight of wearing everything Burberry's.
Try to do more with less. A single piece of statement jewelry, or simple silver pearl earrings...your restraint will be rewarded by increased elegance.
Pick solid colours
If you only could have five new articles of clothing for the whole year, pick clothes of solid colours.
Solid colours can stand repetition much better than patterned materials. Also, again, if you could only have five pieces in your entire wardrobe, I suggest you pick basic or earthy colours such as black, white, ivory, beige, champagne, navy.
Next to build from your wardrobe is to invest into a few pastel-coloured pieces which will add a fresh touch to daytime wear.
With solid colours, you can dress it in different ways by accessorizing. A day time outfit can transform to evening wear by simply removing a scarf and wearing a long strand of pearls.
Avoid being too "matchy, matchy". It may look too 'costume' for anyone to take seriously. Gone were the days where the shoes were made of the same fabric as the bag, the sash and the ribbon on the bonnet.
Although it is advised to exercise restraint in match making, there are somethings to be matched and doing so is very elegant.
For instance, matching the umbrella to your outfit/coat, your various luggage pieces and toiletry bag, your wallet, purse or bag, your lingerie set, the outfit to the occasion.
Your own good taste is probably the best judge.
T Cafe @ Tanah Rata, Cameron Highlands
One of my friend suggested that we go to Cameron Highlands in the next couple of weeks so I got the chance to browse through the internet to check through any interesting place to visit so I found this nice article about T Cafe at Tanah Rata which I might try out if I get the chance to travel to Cameron Highlands with my friend thought of sharing with you guys.
Name: The T-Cafe
Location: Tanah Rata, Cameron Highlands, Pahang
Sausage Pot Pies
I went back home early from work on 1st October to start my baking as there is a department Hari Raya Celebration, everyone of us suppose to bring some food. I have try out this recipe and it is my first attempt, most of my colleague like the taste of it.Ingredients
1.2 kg chicken sausages
1 tablespoon olive oil
1 large onion, chopped
2 cloves garlic, crushed
300g button mushrooms, quatered
2 x 430g cans cream of chicken soup
1/4 cup chopped fresh parsley
1 tablesppon packaged breadcrumbs
1/4 cup grated parmesan cheese
Topping
1.5 kg potatoes
50g butter
11/2 cups milk
1 tablespoon chicken stock powder
Method
1. Pan fry sausages until well browned and cooked through. Drain on absorbent paper, cool. Cut sausages into 2cm lengths.
2. Heat oil in a large pan. Add onion, garlic and mushrooms, cook, stirring, until onion is soft.
3. Combine sausages, onion mixture, undiluted soup and parsley in a large bowl. Divide sausage mixture among six deep, ovenproof dishes ( 2 cup capacity)
4. Topping. Boil, steam or microwave potatoes with butter, milk and stock powder until smooth.
5. Spoon topping into a piping bag fitted with a large, fluted tube. Pipe over sausage mixture in dishes. Sprinkle with combined breadcrumbs and cheese.
6. Cook in a moderate oven, 180C, for about 30 minutes, or until lightly browned and hot.
1 tablespoon olive oil
1 large onion, chopped
2 cloves garlic, crushed
300g button mushrooms, quatered
2 x 430g cans cream of chicken soup
1/4 cup chopped fresh parsley
1 tablesppon packaged breadcrumbs
1/4 cup grated parmesan cheese
Topping
1.5 kg potatoes
50g butter
11/2 cups milk
1 tablespoon chicken stock powder
Method
1. Pan fry sausages until well browned and cooked through. Drain on absorbent paper, cool. Cut sausages into 2cm lengths.
2. Heat oil in a large pan. Add onion, garlic and mushrooms, cook, stirring, until onion is soft.
3. Combine sausages, onion mixture, undiluted soup and parsley in a large bowl. Divide sausage mixture among six deep, ovenproof dishes ( 2 cup capacity)
4. Topping. Boil, steam or microwave potatoes with butter, milk and stock powder until smooth.
5. Spoon topping into a piping bag fitted with a large, fluted tube. Pipe over sausage mixture in dishes. Sprinkle with combined breadcrumbs and cheese.
6. Cook in a moderate oven, 180C, for about 30 minutes, or until lightly browned and hot.
15 Cancer Symton For Women
15 Cancer Symptoms Women Ignore
WebMD uncovers common cancer warning signs women often overlook.
By Kathleen DohenyWebMD Feature
Reviewed by Louise Chang, MD
Women tend to be more vigilant than men about getting recommended health checkups and cancer screenings, according to studies and experts.
They're generally more willing, as well, to get potentially worrisome symptoms checked out, says Mary Daly, MD, oncologist and head of the department of clinical genetics at Fox Chase Cancer Center in Philadelphia.
But not always. Younger women, for instance, tend to ignore symptoms that could point to cancer. "They have this notion that cancer is a problem of older people," Daly tells WebMD. And they're often right, but plenty of young people get cancer, too.
Of course, some women are as skilled as men are at switching to denial mode. "There are people who deliberately ignore their cancer symptoms," says Hannah Linden, MD, a medical oncologist. She is a joint associate member of the Fred Hutchinson Cancer Research Center and associate professor of medicine at the University of Washington School of Medicine, Seattle. It's usually denial, but not always, she says. "For some, there is a cultural belief that cancer is incurable, so why go there."
Talking about worrisome symptoms shouldn't make people overreact, says Ranit Mishori, MD, an assistant professor of family medicine at the Georgetown University School of Medicine in Washington, D.C. "I don't want to give people the impression they should look for every little thing," she says.
With that healthy balance between denial and hypochondria in mind, WebMD asked experts to talk about the symptoms that may not immediately make a woman worry about cancer, but that should be checked out. Read on for 15 possible cancer symptoms women often ignore.
No. 1: Unexplained Weight Loss
Many women would be delighted to lose weight without trying. But unexplained weight loss -- say 10 pounds in a month without an increase in exercise or a decrease in food intake -- should be checked out, Mishori says.
"Unexplained weight loss is cancer unless proven not," she says. It could, of course, turn out to be another condition, such as an overactive thyroid.
Expect your doctor to run tests to check the thyroid and perhaps order a CT scan of different organs. The doctor needs to "rule out the possibilities, one by one," Mishori says.
No. 2: Bloating
Bloating is so common that many women just live with it. But it could point to ovarian cancer. Other symptoms of ovarian cancer include abdominal pain or pelvic pain, feeling full quickly -- even when you haven't eaten much -- and urinary problems, such as having an urgent need to go to the bathroom.
If the bloating occurs almost every day and persists for more than a few weeks, you should consult your physician. Expect your doctor to take a careful history and order a CT scan and blood tests, among others.
No. 3: Breast Changes
Most women know their breasts well, even if they don't do regular self-exams, and know to be on the lookout for lumps. But that's not the only breast symptom that could point to cancer. Redness and thickening of the skin on the breast, which could indicate a very rare but aggressive form of breast cancer, inflammatory breast cancer, also needs to be examined, Linden says. "If you have a rash that persists over weeks, you have to get it evaluated," she says.
Likewise, if the look of a nipple changes, or if you notice discharge (and aren’t breastfeeding), see your doctor. "If it's outgoing normally and turns in," she says, that's not a good sign. "If your nipples are inverted chronically, no big deal." It's the change in appearance that could be a worrisome symptom.
If you have breast changes, expect your doctor to take a careful history, examine the breast, and order tests such as a mammogram, ultrasound, MRI, and perhaps a biopsy.
No. 4: Between-Period Bleeding or Other Unusual Bleeding
''Premenopausal women tend to ignore between-period bleeding," Daly says. They also tend to ignore bleeding from the GI tract, mistakenly thinking it is from their period. But between-period bleeding, especially if you are typically regular, bears checking out, she says. So does bleeding after menopause, as it could be a symptom of endometrial cancer. GI bleeding could be a symptom of colorectal cancer.
Think about what's normal for you, says Debbie Saslow, PhD, director of breast and gynecologic cancer at the American Cancer Society in Atlanta. "If a woman never spots [between periods] and she spots, it's abnormal for her. For someone else, it might not be."
"Endometrial cancer is a common gynecologic cancer," Saslow says. "At least three-quarters who get it have some abnormal bleeding as an early sign."
Your doctor will take a careful history and, depending on the timing of the bleeding and other symptoms, probably order an ultrasound or biopsy.
No. 5: Skin Changes
Most of us know to look for any changes in moles -- a well-known sign of skin cancer. But we should also watch for changes in skin pigmentation, Daly says.
If you suddenly develop bleeding on your skin or excessive scaling, that should be checked, too, she says. It's difficult to say how long is too long to observe skin changes before you go to the doctor, but most experts say not longer than several weeks.
No. 6: Difficulty Swallowing
If you have difficulty swallowing, you may have already changed your diet so chewing isn't so difficult, perhaps turning to soups or liquid foods such as protein shakes.
But that difficulty could be a sign of a GI cancer, such as in the esophagus, says Leonard Lichtenfeld, MD, deputy chief medical officer at the American Cancer Society.
Expect your doctor to take a careful history and order tests such as a chest X-ray or exams of the GI tract.
No. 7: Blood in the Wrong Place
If you notice blood in your urine or your stool, don’t assume it's from a hemorrhoid, says Mishori. "It could be colon cancer."
Expect your doctor to ask questions and perhaps order testing such as a colonoscopy, an exam of the colon to look for cancer.
Seeing blood in the toilet bowl may actually be from the vagina if a woman is menstruating, Mishori says. But if not, it should be checked to rule out bladder or kidney cancer, she says.
Coughing up blood should be evaluated, too. One occasion of blood in the wrong place may not point to anything, Mishori says, but if it happens more than once, go see your doctor.
No. 8: Gnawing Abdominal Pain and Depression
Any woman who's got a pain in the abdomen and is feeling depressed needs a checkup, says Lichtenfeld. Some researchers have found a link between depression and pancreatic cancer, but it's a poorly understood connection.
No. 9: Indigestion
Women who have been pregnant may remember the indigestion that occurred as they gained weight. But indigestion for no apparent reason may be a red flag.
It could be an early clue to cancer of the esophagus, stomach, or throat.
Expect your doctor to take a careful history and ask questions about the indigestion before deciding which tests to order, if any.
No. 10: Mouth Changes
Smokers should be especially alert for any white patches inside the mouth or white spots on the tongue, according to the American Cancer Society. Both can point to a precancerous condition called leukoplakia that can progress to oral cancer.
Ask your dentist or doctor to take a look and decide what should be done next.
No. 11: Pain
As people age they seem to complain more of various aches and pains, but pain, as vague as it may be, can also be an early symptom of some cancers, although most pain complaints are not from cancer.
Pain that persists and is unexplained needs to be checked out. Expect your physician to take a careful history, and based on that information decide what further testing, if any, is needed.
No. 12: Changes in the Lymph Nodes
If you notice a lump or swelling in the lymph nodes under your armpit or in your neck -- or anywhere else -- it could be worrisome, Linden says.
"If you have a lymph node that gets progressively larger, and it's [been] longer than a month, see a doctor," she says. Your doctor will examine you and figure out any associated issues (such as infection) that could explain the lymph node enlargement.
If there are none, your doctor will typically order a biopsy
No. 13: Fever
If you have a fever that isn't explained by influenza or other infection, it could point to cancer. Fevers more often occur after cancer has spread from its original site, but it can also point to early blood cancers such as leukemia or lymphoma, according to the American Cancer Society.
Other cancer symptoms can include jaundice, or a change in the color of your stool.
Expect your doctor to conduct a careful physical exam and take a medical history, and then order tests such as a chest X-ray, CT scan, MRI, or other tests, depending on the findings.
No. 14: Fatigue
Fatigue is another vague symptom that could point to cancer -- as well as a host of other problems. It can set in after the cancer has grown, but it may also occur early in certain cancers, such as leukemia or with some colon or stomach cancers, according to the American Cancer Society.
No. 15: Persistent Cough
Coughs are expected with colds, the flu,
WebMD uncovers common cancer warning signs women often overlook.
By Kathleen DohenyWebMD Feature
Reviewed by Louise Chang, MD
Women tend to be more vigilant than men about getting recommended health checkups and cancer screenings, according to studies and experts.
They're generally more willing, as well, to get potentially worrisome symptoms checked out, says Mary Daly, MD, oncologist and head of the department of clinical genetics at Fox Chase Cancer Center in Philadelphia.
But not always. Younger women, for instance, tend to ignore symptoms that could point to cancer. "They have this notion that cancer is a problem of older people," Daly tells WebMD. And they're often right, but plenty of young people get cancer, too.
Of course, some women are as skilled as men are at switching to denial mode. "There are people who deliberately ignore their cancer symptoms," says Hannah Linden, MD, a medical oncologist. She is a joint associate member of the Fred Hutchinson Cancer Research Center and associate professor of medicine at the University of Washington School of Medicine, Seattle. It's usually denial, but not always, she says. "For some, there is a cultural belief that cancer is incurable, so why go there."
Talking about worrisome symptoms shouldn't make people overreact, says Ranit Mishori, MD, an assistant professor of family medicine at the Georgetown University School of Medicine in Washington, D.C. "I don't want to give people the impression they should look for every little thing," she says.
With that healthy balance between denial and hypochondria in mind, WebMD asked experts to talk about the symptoms that may not immediately make a woman worry about cancer, but that should be checked out. Read on for 15 possible cancer symptoms women often ignore.
No. 1: Unexplained Weight Loss
Many women would be delighted to lose weight without trying. But unexplained weight loss -- say 10 pounds in a month without an increase in exercise or a decrease in food intake -- should be checked out, Mishori says.
"Unexplained weight loss is cancer unless proven not," she says. It could, of course, turn out to be another condition, such as an overactive thyroid.
Expect your doctor to run tests to check the thyroid and perhaps order a CT scan of different organs. The doctor needs to "rule out the possibilities, one by one," Mishori says.
No. 2: Bloating
Bloating is so common that many women just live with it. But it could point to ovarian cancer. Other symptoms of ovarian cancer include abdominal pain or pelvic pain, feeling full quickly -- even when you haven't eaten much -- and urinary problems, such as having an urgent need to go to the bathroom.
If the bloating occurs almost every day and persists for more than a few weeks, you should consult your physician. Expect your doctor to take a careful history and order a CT scan and blood tests, among others.
No. 3: Breast Changes
Most women know their breasts well, even if they don't do regular self-exams, and know to be on the lookout for lumps. But that's not the only breast symptom that could point to cancer. Redness and thickening of the skin on the breast, which could indicate a very rare but aggressive form of breast cancer, inflammatory breast cancer, also needs to be examined, Linden says. "If you have a rash that persists over weeks, you have to get it evaluated," she says.
Likewise, if the look of a nipple changes, or if you notice discharge (and aren’t breastfeeding), see your doctor. "If it's outgoing normally and turns in," she says, that's not a good sign. "If your nipples are inverted chronically, no big deal." It's the change in appearance that could be a worrisome symptom.
If you have breast changes, expect your doctor to take a careful history, examine the breast, and order tests such as a mammogram, ultrasound, MRI, and perhaps a biopsy.
No. 4: Between-Period Bleeding or Other Unusual Bleeding
''Premenopausal women tend to ignore between-period bleeding," Daly says. They also tend to ignore bleeding from the GI tract, mistakenly thinking it is from their period. But between-period bleeding, especially if you are typically regular, bears checking out, she says. So does bleeding after menopause, as it could be a symptom of endometrial cancer. GI bleeding could be a symptom of colorectal cancer.
Think about what's normal for you, says Debbie Saslow, PhD, director of breast and gynecologic cancer at the American Cancer Society in Atlanta. "If a woman never spots [between periods] and she spots, it's abnormal for her. For someone else, it might not be."
"Endometrial cancer is a common gynecologic cancer," Saslow says. "At least three-quarters who get it have some abnormal bleeding as an early sign."
Your doctor will take a careful history and, depending on the timing of the bleeding and other symptoms, probably order an ultrasound or biopsy.
No. 5: Skin Changes
Most of us know to look for any changes in moles -- a well-known sign of skin cancer. But we should also watch for changes in skin pigmentation, Daly says.
If you suddenly develop bleeding on your skin or excessive scaling, that should be checked, too, she says. It's difficult to say how long is too long to observe skin changes before you go to the doctor, but most experts say not longer than several weeks.
No. 6: Difficulty Swallowing
If you have difficulty swallowing, you may have already changed your diet so chewing isn't so difficult, perhaps turning to soups or liquid foods such as protein shakes.
But that difficulty could be a sign of a GI cancer, such as in the esophagus, says Leonard Lichtenfeld, MD, deputy chief medical officer at the American Cancer Society.
Expect your doctor to take a careful history and order tests such as a chest X-ray or exams of the GI tract.
No. 7: Blood in the Wrong Place
If you notice blood in your urine or your stool, don’t assume it's from a hemorrhoid, says Mishori. "It could be colon cancer."
Expect your doctor to ask questions and perhaps order testing such as a colonoscopy, an exam of the colon to look for cancer.
Seeing blood in the toilet bowl may actually be from the vagina if a woman is menstruating, Mishori says. But if not, it should be checked to rule out bladder or kidney cancer, she says.
Coughing up blood should be evaluated, too. One occasion of blood in the wrong place may not point to anything, Mishori says, but if it happens more than once, go see your doctor.
No. 8: Gnawing Abdominal Pain and Depression
Any woman who's got a pain in the abdomen and is feeling depressed needs a checkup, says Lichtenfeld. Some researchers have found a link between depression and pancreatic cancer, but it's a poorly understood connection.
No. 9: Indigestion
Women who have been pregnant may remember the indigestion that occurred as they gained weight. But indigestion for no apparent reason may be a red flag.
It could be an early clue to cancer of the esophagus, stomach, or throat.
Expect your doctor to take a careful history and ask questions about the indigestion before deciding which tests to order, if any.
No. 10: Mouth Changes
Smokers should be especially alert for any white patches inside the mouth or white spots on the tongue, according to the American Cancer Society. Both can point to a precancerous condition called leukoplakia that can progress to oral cancer.
Ask your dentist or doctor to take a look and decide what should be done next.
No. 11: Pain
As people age they seem to complain more of various aches and pains, but pain, as vague as it may be, can also be an early symptom of some cancers, although most pain complaints are not from cancer.
Pain that persists and is unexplained needs to be checked out. Expect your physician to take a careful history, and based on that information decide what further testing, if any, is needed.
No. 12: Changes in the Lymph Nodes
If you notice a lump or swelling in the lymph nodes under your armpit or in your neck -- or anywhere else -- it could be worrisome, Linden says.
"If you have a lymph node that gets progressively larger, and it's [been] longer than a month, see a doctor," she says. Your doctor will examine you and figure out any associated issues (such as infection) that could explain the lymph node enlargement.
If there are none, your doctor will typically order a biopsy
No. 13: Fever
If you have a fever that isn't explained by influenza or other infection, it could point to cancer. Fevers more often occur after cancer has spread from its original site, but it can also point to early blood cancers such as leukemia or lymphoma, according to the American Cancer Society.
Other cancer symptoms can include jaundice, or a change in the color of your stool.
Expect your doctor to conduct a careful physical exam and take a medical history, and then order tests such as a chest X-ray, CT scan, MRI, or other tests, depending on the findings.
No. 14: Fatigue
Fatigue is another vague symptom that could point to cancer -- as well as a host of other problems. It can set in after the cancer has grown, but it may also occur early in certain cancers, such as leukemia or with some colon or stomach cancers, according to the American Cancer Society.
No. 15: Persistent Cough
Coughs are expected with colds, the flu,
Lasek Information
What is Intralasik?
The" Intra" component denotes the use of the Intralase Femtosecond laser and LASIK is an abbreviated term for "Laser Assisted In situ Keratomileusis" With Intralasik, the first step of cutting the flap is accomplished using a highly precise laser, the Intralase Femtosecond Laser.The Intralase software directs the Intralase laser to optically focus its beam into a tiny, 1 micron (.001mm) spot of energy that passes harmlessly through the outer layers of the cornea until reaching its exact depth within the stroma (central layer of the cornea). In an "inside out" process, the laser beam creates a separation plane by forming an interconnecting series of bubbles made of carbon dioxide and water vapor.The laser beam stacks a pattern of bubbles along the periphery of the treatment plane, leaving an unseparated section of tissue to act as a hinge. As with a traditional LASIK approach, the surgeon then folds the tissue back to expose the underlying corneal layer to prepare for the excimer laser treatment that will re-shape the cornea. With Intralasik, surgeons can avoid the complications related to surgical blade problems. The Intralase laser precisely delivers the laser energy directly to the outer surface of the cornea, which suffers no trauma. A higher degree of accuracy in both the depth and size of the corneal flap is now possible with Intralase.
There are a number of valuable benefits that this form of surgery provides.1) SafetyThis is the most valuable advantage of Intralasik and the main reason why Optimax invested in this expensive technology. With the accuracy and safety checks offered by Intralase, major complications do not occur.2) PrecisionFlap measurements are highly accurate.This provides the surgeon with confidence to :a) Treat patients previously rejected because of thin corneas.b) Avoid the risk of ectasia - a complication that can occur from an unexpectedly thick flap. In ectasia the cornea is thinned beyond the margin of safety resulting in instability.c) No induced changes in refraction which can occur with irregularly thick flaps from LASIK affecting visual outcome.3) OutcomesBy being able to cut the initial flap in such a controlled fashion, we are able to closely predict our results. In creating such precise and uniform flaps we avoid surprises of new astigmatism and aberrations.TechnologyIntralase FS60 for flap creation on IntraLasik, Custom IntraLasik andPAC IntraLasik.The VASTLY IMPROVED 4th GENERATION INTRALASE called the IntraLase-FS60 (femtosecond) has been introduced at Optimax ,Malaysia to create BLADE-FREE LASIK flaps.( The conventional alternative, is when the LASIK flap was created using a microkeratome with a blade.)4th GENERATION INTRALASE-FS60 HAS VAST IMPROVEMENTS FROM LESSONS LEARNT FROM THE 1ST GENERATION INTRALASE:• Twice as fast procedure time (usually less than 20 seconds). • Enhanced patient comfort and safety during the procedure. • Improved flap quality creation software. • Smoother corneal surfaces than before, for better results. • Administers less energy to the cornea for greater safety.THINNER FLAPS CAN BE CREATED TO SAVE CORNEAL TISSUE!Of course the biggest benefit of 4th Generation IntraLase-FS60 is the increased SAFETY and PRECISION from its older version of ALL-LASER BLADE-FREE procedure.How does IntraLase-FS60 Laser Work?
• Pulsing at a speed of one-quadrillionth of a second, the laser uses an infrared beam of light to prepare the flap. • The Intralase has pulses that are focused within the tissue to create an incision below the surface of the corneal tissue. • A series of closely-spaced bubbles of 2-3 micron in diameter each, is created, which are absorbed into the tissue and leave a cavity in the stroma. (Hence the tissue above created is the flap used for Lasik) • The process takes under 15 seconds, on average ( twice faster than the older version). • The surgeon then lifts the flap to proceed with the Excimer Laser sculpting. • The surgeon can precisely control laser specifications for flap diameter, depth, and edge angle.
In short there is no longer any worry about irregular or non-perfect flaps for Lasik!
Customized Treatment
Introduction Customized treatment, also known as wavefront laser or wavefront-guided laser, uses 3-dimensional measurements of how your eye processes images to guide the laser in re-shaping the front part of the eye which is the cornea. With a wavefront measurement system, some extremely precise, individualized vision correction outcomes that would be impossible with conventional lasik surgery, contact lenses or spectacles may be achieved.
Wavefront-guided treatment provides the most technologically advanced measurement not just of standard visual but also of scattered light errors known as 'aberrations'. Wavefront technology or aberrometry is based on the principle that if an eye had no imperfections at all, light passed through it would not scatter. But because no eye is perfect, light scatters to form distinct patterns - called a wavefront. Wavefront technology measures your personal/individual patterns and thus allows the surgeon to plan a treatment that exactly matches individual vision errors.
With customized treatment, your eye's ability to focus light rays is measured, and a 3-D map is created that demonstrates irregularities in the way your eye processes images. Information contained in the map guides the laser in customizing the treatment to reshape your eye's corneal surface so that these irregularities can be corrected. Standard prescriptions for glasses, contacts, or traditional LASIK procedures can correct ordinary vision defects such as myopia (short-sightedness), hyperopia (long-sightedness), and astigmatism. But other irregularities associated with the eye's optical system could not be addressed until the advent of wavefront and related technology used in the customized treatment. Wavefront technology has the potential to improve not only how much you can see, but also how well you can see. This reduces the risk of post-LASIK complications, such as glare, halos and difficulty with night vision.
How much you see depends on vision defects known as lower-order aberrations associated with common refractive errors including myopia, hyperopia, and astigmatism, which traditional LASIK can treat. How well you see can depend on presence of the type and numbers of visual distortions known as higher-order aberrations, which can include irregularities caused by the irregularities of the cornea other than common refractive errors. These higher-order aberrations can create problems such as decreased night vision, glare, shadows and halos. However, higher-order aberrations may or may not affect vision. Unlike traditional LASIK, customized laser treats both lower- and higher-order aberrations. Custom LASIK's advantage lies in the area of quality of vision: 1. Greater chance of achieving 20/20 vision. 2. Reduced chance of losing visual quality. 3. Reduced chance of night-vision disturbances and glare.
Technology - How Custom LASIK Works Using the wavefront device to transmit a safe ray of light into your eye, the light is then reflected back off the retina, out through the pupil, and into the wavefront device, where the reflected wave of light is received and arranged into a unique pattern that captures your lower- and higher-order aberrations. All of these visual irregularities are then displayed as a 3-D map, referred to as a wavefront map. This information is then electronically transferred to the laser (in wavefront-guided systems), and computer-matched to the eye's position, enabling the surgeon to customize the LASIK procedure to your unique visual requirements.
FAQ What is Customized LASIK? Customized LASIK is a technology where the tissue removal pattern is tailor-made for each of your eyes. It sets out to improve overall visual quality in terms of contrast sensitivity and fine detail as well as to reduce higher order aberrations such as haloes, glare for night vision. What is the difference between customized and conventional LASIK? Conventional LASIK can provide excellent results when correcting a wide range of vision problem like short-sightedness, long-sightedness and astigmatism, these vision problems are known as lower order aberrations. Customized LASIK goes beyond reshaping your cornea based on prescription; it also corrects other imperfections in your optical system that may affect the clarity of your vision and how well you see at night and in low light that previously could not be detected. These are known as higher order aberrations which contribute to glare, shadows, halos and other annoying visual effects. Unless these higher order aberrations can be addressed along with the lower order aberrations, the quality of your vision may not be ideal, even if you have measurable vision of 20/20.
Optimax's Customized Treatment With the various laser machines available, Optimax is offering the different customized platforms that cater for different eyes
LADARWaveTM Wavefront (CustomCornea® - ALCON)
ZywaveTM Aberrometer (Zyoptix 100- Bausch & Lomb)
WASCA Analyzer (Carl Zeiss)
OPDScan Aberrometer (NIDEK)
---------------------------------
Risks of LASIK Surgery
Before getting involved with any surgery, you should educate yourself about the risks. This is true of LASIK.
LASIK ComplicationsThere are several complications associated with LASIK procedures, some more prevalent than others. How do you know if you have to worry? Most studies conducted during the late 1990s suggest the risk of complications averaged 5%.
Since that time however, newer technology and better-qualified surgeons now report the risks associated with LASIK are more along the lines of 1%. This of course, only applies to patients that are meticulously screened prior to surgery. The good news is most of these complications resolve relatively quickly after surgery or are temporary.
Among the more commonly reported complications of surgery are flap complications. Flap complications occur in the hinged flap covering the front of the cornea. Doctors typically lift this flap to reshape the cornea then replace so the flap serves as a bandage.
One of the risks associated with cutting the flap using a microkeratome is abrasion. However, new technology including use of IntraLase technology has limited this risk significantly.
Some studies suggest cutting a flap and then using custom LASIK procedures may result in adverse outcomes, in part because surgeons don't use custom procedures to create the hinged eye flap. Therefore replacing it over the reshaped cornea may result in less than optimal outcomes.
Another risk associated with LASIK is Diffuse Lamellar Keratitis or DLK. Many call this disorder the "Sands of the Sahara". It results when dead cells lodge beneath the corneal flap. The cornea mistakenly assumes these cells are harmful and initiates an inflammatory response. Unfortunately this may result in scarring, and permanent vision loss may occur if prompt treatment is not initiated.
Irregular AstigmatismOne common side effect resulting from traditional procedures is irregular astigmatism. This can result when laser correction isn't conducted properly or when the corneal surface is not smooth. The symptoms can include seeing double. Many patients experiencing this complication will need additional surgery to correct the problem.
Sometimes double vision is caused by minor swelling after surgery and resolves itself.
Other Common ComplicationsHere is a list of some other complications associated with LASIK:
Keratectasia - This condition results when a surgeon cuts the flap too deeply or removes too much tissue during surgery. This results in weakening and bulging of the cornea. Distorted vision may be permanent.
Dry eye - Dry eye is a much more commonly reported side effect of LASIK surgery. This can contribute to inflammation and infection, but is typically resolved using artificial tears.
Infection - Some patients will develop infections following surgery. Fortunately the risk of infection is relatively low. Some doctors prescribe prophylatic antibiotics to help reduce the risk of infection.
Night Vision Problems - These are more common when surgeons use traditional LASIK procedures. They may also result when the surgeon treats too small of an area surrounding the pupil.
Over or under correction - This can result in blurry vision or minor visual disturbances. Many times patients will have to wear contact lenses or glasses to resolve the problem. Re-treatment with the laser is often possible.
It is important you carefully weigh your risk of complications and side effects when talking with your doctor. Your doctor can help you make an educated decision and decide whether the benefits of surgery outweigh the risks.
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LASIK Risks and Complications
By Marilyn Haddrill, with updates by Gary Heiting, OD; reviewed by Brian S. Boxer Wachler, MD
If you are considering LASIK and are worried that something could go wrong, you might take comfort in knowing that sight-threatening complications from laser vision correction are rare. Also, many LASIK complications can be resolved with additional surgery or medical treatment.
Choosing the right eye surgeon probably is the single most important step you can take to decrease any risks associated with LASIK. An experienced, reputable surgeon will make sure you are properly screened and let you know up front if you aren't a good candidate for LASIK eye surgery.
Even if you are not qualified for LASIK, you still might be able to undergo vision correction surgery through other means such as PRK, LASEK, or implantable lenses. If you do decide to have LASIK, a responsible eye surgeon will work closely with you to resolve problems if they do develop. You can choose a LASIK surgeon by taking certain steps such as checking credentials.
How Common Are LASIK Complications?
Public confidence in LASIK has grown in recent years because of a solid success rate involving millions of successful procedures performed in the United States. With increasingly sophisticated technology being used for the procedure, most LASIK outcomes these days are very favorable.
The U.S. military also has adopted widespread use of refractive surgery including LASIK to decrease reliance of troops on corrective eyewear. This trend is particularly relevant because troops deployed for active duty are not allowed to wear contact lenses.
As of 2008, more than 224,000 military personnel had undergone laser vision correction. Since the procedure first was introduced in the military in 2000, researchers have conducted more than 45 studies regarding safety and effectiveness of LASIK and other procedures.
Outcomes have been overwhelmingly positive. Most soldiers see 20/20 or better after the procedure without corrective eyewear, and the rate of complications has been very low. According to one study, only one in 112,500 patients required medical disability retirement due to complications from laser vision correction during this eight-year period.
In a recent study of aviators from the U.S. Navy and U.S. Marine Corps who underwent wavefront-guided LASIK, all patients attained 20/20 uncorrected visual acuity (UCVA) within two weeks after surgery. When questioned about their satisfaction one month after surgery, 95 percent of the patients said the procedure was helpful to their effectiveness as an aviator, and 100 percent said they would recommend it to other aviators. Study results were presented at the 2008 annual meeting of the American Society of Cataract and Refractive Surgery (ASCRS).
Retired U.S. Navy Capt. Steven C. Schallhorn, MD, a former fighter pilot and the first U.S. Department of Defense eye surgeon to perform refractive surgery, says he favors wavefront-guided LASIK because of outcomes producing superior night vision vital to the performance of fighter pilots.
LASIK Complication Rates Are Decreasing
The safety and effectiveness of LASIK continue to improve. Complications generally were more common in the early years of LASIK, when studies in the late 1990s indicated that up to 5 percent of people undergoing laser vision correction experienced some type of problem.
Experienced LASIK surgeons now report that serious complication rates can be held well below 1 percent, but only if surgical candidates are selected very carefully. For example, you may be eliminated as a LASIK candidate if you have certain pre-existing conditions, such as diabetes, that may affect how well your eye heals.
It's very important that you mention any health conditions you have and any medicines you take during your LASIK pre-operative exam and consultation. Your eye surgeon needs to know this information to properly assess your suitability for laser vision correction and your risk for complications. It is especially important to discuss any health condition you have that might hamper your ability to heal; this is one of the standard LASIK criteria used for assessment.
Also, you might want to take AllAboutVision.com's online LASIK screening quiz to help you anticipate what kinds of questions you may be asked to determine if you are a good candidate.
Make sure you mention any problem with dry eyes, which is one of the most common reasons you may be eliminated as a candidate. However, many people with mild to moderate dry eyes can be treated before LASIK or other laser vision correction is performed.
The Truth About LASIK Risks
Left: What someone with post-op starbursts might see at night. Right: Nighttime haloes.
While LASIK outcomes overwhelmingly are favorable, remember that — as with any surgery — risks of complications still exist. Fewer than 1 percent of patients still experience serious and ongoing vision problems following LASIK, because no surgical procedure is ever risk-free.
Even people who have excellent uncorrected visual acuity after LASIK based on eye chart testing still can have bothersome side effects. For example, it is rare but possible that you may see 20/20 or better after LASIK but still have symptoms such as double vision, unresolved dry eyes or difficulty seeing at night because of glare or halos around lights.
When you sign the LASIK consent form provided by your eye surgeon prior to surgery, you should do so with a full understanding that, even in the best of circumstances, a slight chance exists that something unintended could occur.
Thankfully, most cases of undesired outcomes after LASIK can be corrected with additional surgery (called an enhancement) or with medical treatment, such as in the case of dry eyes.
Common LASIK Complications
When LASIK complications occur, they may be associated with the creation of a hinged flap in the clear front covering of the eye (cornea), which is lifted for laser re-shaping of the eye. The flap then is replaced to form a type of natural bandage.
If the LASIK flap is not made correctly, it may fail to adhere correctly to the eye's surface. The flap also might be cut too thinly or thickly. After the flap is placed back on the eye's surface, it might begin to wrinkle. These microscopic wrinkles in the flap are called corneal striae.
These flap complications can lead to an irregularly shaped eye surface. Most such problems can be resolved through re-treatment of the eye with enhancement surgery.
Studies indicate that flap complications occur in from 0.3 percent to 5.7 percent of LASIK procedures, according to the April 2006 issue of American Journal of Ophthalmology. But inexperienced surgeons definitely contribute to the higher rates of flap complications. Again, remember that you can reduce your risk of LASIK complications by choosing a reputable, experienced eye surgeon.
Some problems associated with LASIK flap complications include:
Irregular astigmatism can result from a less than smooth corneal surface. Irregular astigmatism also can occur from laser correction that is not centered properly on the eye. Resulting symptoms may include double vision (diplopia) or "ghost images." In these cases, the eye may need re-treatment or an enhancement.
Diffuse Lamellar Keratitis (DLK), nicknamed "Sands of the Sahara," is inflammation under the LASIK flap that may have several causes. Some inflammation of the cornea after LASIK surgery is normal. But if it is uncontrolled, as in DLK, it can interfere with healing and cause vision loss. If DLK occurs, it usually responds to therapies such as antibiotics and topical steroids. The flap also might need to be lifted and rinsed for removal of inflammatory cells and to prevent tissue damage.
Keratectasia or keratoconus is bulging of the eye's surface that can result from a flap that is cut too deeply, when too much tissue is removed from the cornea during LASIK or when the cornea initially was weakened as evidenced from cornea topography mapping prior to LASIK. Resulting distorted vision likely cannot be corrected with laser enhancement, and gas permeable contact lenses or corneal implants (Intacs) may be prescribed to hold the cornea in place.
A promising new treatment for keratectasia (also called "ectasia") is corneal collagen cross-linking with riboflavin (C3-R). In this non-invasive procedure, eye drops containing riboflavin (vitamin B2) are placed on the cornea and then are activated with ultraviolet (UV) light. This strengthens the links between the collagen connective tissue fibers within the cornea to halt the bulging of the eye's surface.
In some cases, it may be possible to perform a laser enhancement of the eye after collagen cross-linking treatment to restore vision loss caused by post-LASIK ectasia or keratoconus.
LASIK Complications: How They Affect You and How They Are Treated
Complications
Symptoms
Treatments
Incomplete corrections (undercorrection, overcorrection, residual astigmatism) or regression of effect
Blurry, less-than-perfect vision
Glasses or contact lenses; eyedrops; re-treatment with laser
Decentered ablations
Visual aberrations*
Eyedrops; re-treatment with laser
Oversize pupils (pupils wider than treatment zone)
Visual aberrations*
Eyedrops; re-treatment with laser
Haze
Visual aberrations*
Eyedrops; re-treatment with laser
Irregular flap (folds, wrinkles, striae)
Visual aberrations*
Surgical correction; second laser procedure
Dry eye
Dry, itchy or scratchy eyes, often with redness and sense of foreign object in eye, and sometimes pain
Prescription dry eye medication; artificial tears; punctal occlusion (blockage of tear ducts in order to retain tear film on eye), oral flaxseed oil
Diffuse lamellar keratitis (eye inflammation)
Visual aberrations*
Eyedrops; surgical rinsing of cells
Epithelial ingrowth
Visual aberrations*
Surgical removal of epithelium
Infection
Redness, oozing of eyes, sometimes pain
Eyedrops; oral medications
*Visual aberrations include symptoms such as glare, double vision, ghosting, halos, starbursts, loss of contrast sensitivity, and problems with low-light or night vision. Not all patients experience all symptoms, and some patients with these complications experience no symptoms and require no treatment. [See also: Higher-Order Aberrations.] Chart created by Keith Croes and reviewed by Brian Boxer Wachler, MD.
Other, more commonly reported complications that can result from LASIK eye surgery include:
Dry Eye After LASIK: Almost half of all patients report problems with dry eyes in the first six months following LASIK, according to the April 2006 issue of American Journal of Ophthalmology. These complaints appear related to reduced sensitivity of the eye's surface immediately following the procedure. If you have this problem, temporary remedies such as artificial tears or prescription dry eye medication may be needed along with oral flaxseed oil capsules. After about six months to a year, however, most dry eye complaints disappear when healing of the eye is complete. People who already have severe dry eye usually are eliminated as LASIK candidates.
Significant Undercorrection, Overcorrection, or Regression: This means that your outcome is less than optimal and makes it difficult to function in certain situations. There are various reasons for these problems. In many cases, the cause is simply that a patient's eyes did not respond to laser eye surgery in a predictable fashion. But it's also possible that results are related to an inaccurate diagnosis or incorrect settings programmed into software guiding the laser during eye surgery. Regression from "over-healing" occurs when your eyesight is optimal at first, but then begins to deteriorate over time. In most cases, a significant undercorrection or regression can be treated with additional laser vision correction or other refractive surgery methods such as conductive keratoplasty, once it is certain that the refractive error is stable.
Eye Infection or Irritation: These problems are rare and may require treatment with eye drops containing antibiotics or anti-inflammatory medication such as steroids. When bacterial infection occurs after LASIK, it appears to be related increasingly to an antibiotic-resistant form of Staphylococcus aureus. Survey results indicating a growing problem with this type of infection were reported at the 2008 annual meeting of ASCRS. LASIK surgeons also reported that infections occurred more frequently with surface ablations such as PRK and when bladed instruments called microkeratomes are used to create the flap during LASIK surgery. ASCRS reports indicate that flaps that are lifted and replaced on the eye during LASIK, serving as a type of "natural" bandage, appear to create a more sterile surgical environment than PRK and other surface ablation procedures.
A Note About Presbyopia and Cataracts
If you are under age 40 when you undergo LASIK, remember that your reading vision naturally will change when you are older, due to presbyopia. Normal age-related changes in the flexibility of your eye's natural lens will cause you to slowly lose the ability to focus at closer distances. If you are nearsighted, you will lose your near vision when you wear your glasses but may be able to read comfortably by removing them.
Presbyopia is not caused by LASIK and will occur whether or not you have refractive surgery. You also might want to review options for eye surgery to correct presbyopia.
As you grow older, you also might develop cataracts. Again, this problem is unrelated to LASIK surgery. If you develop cataracts after LASIK, this is purely coincidental. Having LASIK will not limit your ability to have cataract surgery in the future, if that becomes necessary
The" Intra" component denotes the use of the Intralase Femtosecond laser and LASIK is an abbreviated term for "Laser Assisted In situ Keratomileusis" With Intralasik, the first step of cutting the flap is accomplished using a highly precise laser, the Intralase Femtosecond Laser.The Intralase software directs the Intralase laser to optically focus its beam into a tiny, 1 micron (.001mm) spot of energy that passes harmlessly through the outer layers of the cornea until reaching its exact depth within the stroma (central layer of the cornea). In an "inside out" process, the laser beam creates a separation plane by forming an interconnecting series of bubbles made of carbon dioxide and water vapor.The laser beam stacks a pattern of bubbles along the periphery of the treatment plane, leaving an unseparated section of tissue to act as a hinge. As with a traditional LASIK approach, the surgeon then folds the tissue back to expose the underlying corneal layer to prepare for the excimer laser treatment that will re-shape the cornea. With Intralasik, surgeons can avoid the complications related to surgical blade problems. The Intralase laser precisely delivers the laser energy directly to the outer surface of the cornea, which suffers no trauma. A higher degree of accuracy in both the depth and size of the corneal flap is now possible with Intralase.
There are a number of valuable benefits that this form of surgery provides.1) SafetyThis is the most valuable advantage of Intralasik and the main reason why Optimax invested in this expensive technology. With the accuracy and safety checks offered by Intralase, major complications do not occur.2) PrecisionFlap measurements are highly accurate.This provides the surgeon with confidence to :a) Treat patients previously rejected because of thin corneas.b) Avoid the risk of ectasia - a complication that can occur from an unexpectedly thick flap. In ectasia the cornea is thinned beyond the margin of safety resulting in instability.c) No induced changes in refraction which can occur with irregularly thick flaps from LASIK affecting visual outcome.3) OutcomesBy being able to cut the initial flap in such a controlled fashion, we are able to closely predict our results. In creating such precise and uniform flaps we avoid surprises of new astigmatism and aberrations.TechnologyIntralase FS60 for flap creation on IntraLasik, Custom IntraLasik andPAC IntraLasik.The VASTLY IMPROVED 4th GENERATION INTRALASE called the IntraLase-FS60 (femtosecond) has been introduced at Optimax ,Malaysia to create BLADE-FREE LASIK flaps.( The conventional alternative, is when the LASIK flap was created using a microkeratome with a blade.)4th GENERATION INTRALASE-FS60 HAS VAST IMPROVEMENTS FROM LESSONS LEARNT FROM THE 1ST GENERATION INTRALASE:• Twice as fast procedure time (usually less than 20 seconds). • Enhanced patient comfort and safety during the procedure. • Improved flap quality creation software. • Smoother corneal surfaces than before, for better results. • Administers less energy to the cornea for greater safety.THINNER FLAPS CAN BE CREATED TO SAVE CORNEAL TISSUE!Of course the biggest benefit of 4th Generation IntraLase-FS60 is the increased SAFETY and PRECISION from its older version of ALL-LASER BLADE-FREE procedure.How does IntraLase-FS60 Laser Work?
• Pulsing at a speed of one-quadrillionth of a second, the laser uses an infrared beam of light to prepare the flap. • The Intralase has pulses that are focused within the tissue to create an incision below the surface of the corneal tissue. • A series of closely-spaced bubbles of 2-3 micron in diameter each, is created, which are absorbed into the tissue and leave a cavity in the stroma. (Hence the tissue above created is the flap used for Lasik) • The process takes under 15 seconds, on average ( twice faster than the older version). • The surgeon then lifts the flap to proceed with the Excimer Laser sculpting. • The surgeon can precisely control laser specifications for flap diameter, depth, and edge angle.
In short there is no longer any worry about irregular or non-perfect flaps for Lasik!
Customized Treatment
Introduction Customized treatment, also known as wavefront laser or wavefront-guided laser, uses 3-dimensional measurements of how your eye processes images to guide the laser in re-shaping the front part of the eye which is the cornea. With a wavefront measurement system, some extremely precise, individualized vision correction outcomes that would be impossible with conventional lasik surgery, contact lenses or spectacles may be achieved.
Wavefront-guided treatment provides the most technologically advanced measurement not just of standard visual but also of scattered light errors known as 'aberrations'. Wavefront technology or aberrometry is based on the principle that if an eye had no imperfections at all, light passed through it would not scatter. But because no eye is perfect, light scatters to form distinct patterns - called a wavefront. Wavefront technology measures your personal/individual patterns and thus allows the surgeon to plan a treatment that exactly matches individual vision errors.
With customized treatment, your eye's ability to focus light rays is measured, and a 3-D map is created that demonstrates irregularities in the way your eye processes images. Information contained in the map guides the laser in customizing the treatment to reshape your eye's corneal surface so that these irregularities can be corrected. Standard prescriptions for glasses, contacts, or traditional LASIK procedures can correct ordinary vision defects such as myopia (short-sightedness), hyperopia (long-sightedness), and astigmatism. But other irregularities associated with the eye's optical system could not be addressed until the advent of wavefront and related technology used in the customized treatment. Wavefront technology has the potential to improve not only how much you can see, but also how well you can see. This reduces the risk of post-LASIK complications, such as glare, halos and difficulty with night vision.
How much you see depends on vision defects known as lower-order aberrations associated with common refractive errors including myopia, hyperopia, and astigmatism, which traditional LASIK can treat. How well you see can depend on presence of the type and numbers of visual distortions known as higher-order aberrations, which can include irregularities caused by the irregularities of the cornea other than common refractive errors. These higher-order aberrations can create problems such as decreased night vision, glare, shadows and halos. However, higher-order aberrations may or may not affect vision. Unlike traditional LASIK, customized laser treats both lower- and higher-order aberrations. Custom LASIK's advantage lies in the area of quality of vision: 1. Greater chance of achieving 20/20 vision. 2. Reduced chance of losing visual quality. 3. Reduced chance of night-vision disturbances and glare.
Technology - How Custom LASIK Works Using the wavefront device to transmit a safe ray of light into your eye, the light is then reflected back off the retina, out through the pupil, and into the wavefront device, where the reflected wave of light is received and arranged into a unique pattern that captures your lower- and higher-order aberrations. All of these visual irregularities are then displayed as a 3-D map, referred to as a wavefront map. This information is then electronically transferred to the laser (in wavefront-guided systems), and computer-matched to the eye's position, enabling the surgeon to customize the LASIK procedure to your unique visual requirements.
FAQ What is Customized LASIK? Customized LASIK is a technology where the tissue removal pattern is tailor-made for each of your eyes. It sets out to improve overall visual quality in terms of contrast sensitivity and fine detail as well as to reduce higher order aberrations such as haloes, glare for night vision. What is the difference between customized and conventional LASIK? Conventional LASIK can provide excellent results when correcting a wide range of vision problem like short-sightedness, long-sightedness and astigmatism, these vision problems are known as lower order aberrations. Customized LASIK goes beyond reshaping your cornea based on prescription; it also corrects other imperfections in your optical system that may affect the clarity of your vision and how well you see at night and in low light that previously could not be detected. These are known as higher order aberrations which contribute to glare, shadows, halos and other annoying visual effects. Unless these higher order aberrations can be addressed along with the lower order aberrations, the quality of your vision may not be ideal, even if you have measurable vision of 20/20.
Optimax's Customized Treatment With the various laser machines available, Optimax is offering the different customized platforms that cater for different eyes
LADARWaveTM Wavefront (CustomCornea® - ALCON)
ZywaveTM Aberrometer (Zyoptix 100- Bausch & Lomb)
WASCA Analyzer (Carl Zeiss)
OPDScan Aberrometer (NIDEK)
---------------------------------
Risks of LASIK Surgery
Before getting involved with any surgery, you should educate yourself about the risks. This is true of LASIK.
LASIK ComplicationsThere are several complications associated with LASIK procedures, some more prevalent than others. How do you know if you have to worry? Most studies conducted during the late 1990s suggest the risk of complications averaged 5%.
Since that time however, newer technology and better-qualified surgeons now report the risks associated with LASIK are more along the lines of 1%. This of course, only applies to patients that are meticulously screened prior to surgery. The good news is most of these complications resolve relatively quickly after surgery or are temporary.
Among the more commonly reported complications of surgery are flap complications. Flap complications occur in the hinged flap covering the front of the cornea. Doctors typically lift this flap to reshape the cornea then replace so the flap serves as a bandage.
One of the risks associated with cutting the flap using a microkeratome is abrasion. However, new technology including use of IntraLase technology has limited this risk significantly.
Some studies suggest cutting a flap and then using custom LASIK procedures may result in adverse outcomes, in part because surgeons don't use custom procedures to create the hinged eye flap. Therefore replacing it over the reshaped cornea may result in less than optimal outcomes.
Another risk associated with LASIK is Diffuse Lamellar Keratitis or DLK. Many call this disorder the "Sands of the Sahara". It results when dead cells lodge beneath the corneal flap. The cornea mistakenly assumes these cells are harmful and initiates an inflammatory response. Unfortunately this may result in scarring, and permanent vision loss may occur if prompt treatment is not initiated.
Irregular AstigmatismOne common side effect resulting from traditional procedures is irregular astigmatism. This can result when laser correction isn't conducted properly or when the corneal surface is not smooth. The symptoms can include seeing double. Many patients experiencing this complication will need additional surgery to correct the problem.
Sometimes double vision is caused by minor swelling after surgery and resolves itself.
Other Common ComplicationsHere is a list of some other complications associated with LASIK:
Keratectasia - This condition results when a surgeon cuts the flap too deeply or removes too much tissue during surgery. This results in weakening and bulging of the cornea. Distorted vision may be permanent.
Dry eye - Dry eye is a much more commonly reported side effect of LASIK surgery. This can contribute to inflammation and infection, but is typically resolved using artificial tears.
Infection - Some patients will develop infections following surgery. Fortunately the risk of infection is relatively low. Some doctors prescribe prophylatic antibiotics to help reduce the risk of infection.
Night Vision Problems - These are more common when surgeons use traditional LASIK procedures. They may also result when the surgeon treats too small of an area surrounding the pupil.
Over or under correction - This can result in blurry vision or minor visual disturbances. Many times patients will have to wear contact lenses or glasses to resolve the problem. Re-treatment with the laser is often possible.
It is important you carefully weigh your risk of complications and side effects when talking with your doctor. Your doctor can help you make an educated decision and decide whether the benefits of surgery outweigh the risks.
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LASIK Risks and Complications
By Marilyn Haddrill, with updates by Gary Heiting, OD; reviewed by Brian S. Boxer Wachler, MD
If you are considering LASIK and are worried that something could go wrong, you might take comfort in knowing that sight-threatening complications from laser vision correction are rare. Also, many LASIK complications can be resolved with additional surgery or medical treatment.
Choosing the right eye surgeon probably is the single most important step you can take to decrease any risks associated with LASIK. An experienced, reputable surgeon will make sure you are properly screened and let you know up front if you aren't a good candidate for LASIK eye surgery.
Even if you are not qualified for LASIK, you still might be able to undergo vision correction surgery through other means such as PRK, LASEK, or implantable lenses. If you do decide to have LASIK, a responsible eye surgeon will work closely with you to resolve problems if they do develop. You can choose a LASIK surgeon by taking certain steps such as checking credentials.
How Common Are LASIK Complications?
Public confidence in LASIK has grown in recent years because of a solid success rate involving millions of successful procedures performed in the United States. With increasingly sophisticated technology being used for the procedure, most LASIK outcomes these days are very favorable.
The U.S. military also has adopted widespread use of refractive surgery including LASIK to decrease reliance of troops on corrective eyewear. This trend is particularly relevant because troops deployed for active duty are not allowed to wear contact lenses.
As of 2008, more than 224,000 military personnel had undergone laser vision correction. Since the procedure first was introduced in the military in 2000, researchers have conducted more than 45 studies regarding safety and effectiveness of LASIK and other procedures.
Outcomes have been overwhelmingly positive. Most soldiers see 20/20 or better after the procedure without corrective eyewear, and the rate of complications has been very low. According to one study, only one in 112,500 patients required medical disability retirement due to complications from laser vision correction during this eight-year period.
In a recent study of aviators from the U.S. Navy and U.S. Marine Corps who underwent wavefront-guided LASIK, all patients attained 20/20 uncorrected visual acuity (UCVA) within two weeks after surgery. When questioned about their satisfaction one month after surgery, 95 percent of the patients said the procedure was helpful to their effectiveness as an aviator, and 100 percent said they would recommend it to other aviators. Study results were presented at the 2008 annual meeting of the American Society of Cataract and Refractive Surgery (ASCRS).
Retired U.S. Navy Capt. Steven C. Schallhorn, MD, a former fighter pilot and the first U.S. Department of Defense eye surgeon to perform refractive surgery, says he favors wavefront-guided LASIK because of outcomes producing superior night vision vital to the performance of fighter pilots.
LASIK Complication Rates Are Decreasing
The safety and effectiveness of LASIK continue to improve. Complications generally were more common in the early years of LASIK, when studies in the late 1990s indicated that up to 5 percent of people undergoing laser vision correction experienced some type of problem.
Experienced LASIK surgeons now report that serious complication rates can be held well below 1 percent, but only if surgical candidates are selected very carefully. For example, you may be eliminated as a LASIK candidate if you have certain pre-existing conditions, such as diabetes, that may affect how well your eye heals.
It's very important that you mention any health conditions you have and any medicines you take during your LASIK pre-operative exam and consultation. Your eye surgeon needs to know this information to properly assess your suitability for laser vision correction and your risk for complications. It is especially important to discuss any health condition you have that might hamper your ability to heal; this is one of the standard LASIK criteria used for assessment.
Also, you might want to take AllAboutVision.com's online LASIK screening quiz to help you anticipate what kinds of questions you may be asked to determine if you are a good candidate.
Make sure you mention any problem with dry eyes, which is one of the most common reasons you may be eliminated as a candidate. However, many people with mild to moderate dry eyes can be treated before LASIK or other laser vision correction is performed.
The Truth About LASIK Risks
Left: What someone with post-op starbursts might see at night. Right: Nighttime haloes.
While LASIK outcomes overwhelmingly are favorable, remember that — as with any surgery — risks of complications still exist. Fewer than 1 percent of patients still experience serious and ongoing vision problems following LASIK, because no surgical procedure is ever risk-free.
Even people who have excellent uncorrected visual acuity after LASIK based on eye chart testing still can have bothersome side effects. For example, it is rare but possible that you may see 20/20 or better after LASIK but still have symptoms such as double vision, unresolved dry eyes or difficulty seeing at night because of glare or halos around lights.
When you sign the LASIK consent form provided by your eye surgeon prior to surgery, you should do so with a full understanding that, even in the best of circumstances, a slight chance exists that something unintended could occur.
Thankfully, most cases of undesired outcomes after LASIK can be corrected with additional surgery (called an enhancement) or with medical treatment, such as in the case of dry eyes.
Common LASIK Complications
When LASIK complications occur, they may be associated with the creation of a hinged flap in the clear front covering of the eye (cornea), which is lifted for laser re-shaping of the eye. The flap then is replaced to form a type of natural bandage.
If the LASIK flap is not made correctly, it may fail to adhere correctly to the eye's surface. The flap also might be cut too thinly or thickly. After the flap is placed back on the eye's surface, it might begin to wrinkle. These microscopic wrinkles in the flap are called corneal striae.
These flap complications can lead to an irregularly shaped eye surface. Most such problems can be resolved through re-treatment of the eye with enhancement surgery.
Studies indicate that flap complications occur in from 0.3 percent to 5.7 percent of LASIK procedures, according to the April 2006 issue of American Journal of Ophthalmology. But inexperienced surgeons definitely contribute to the higher rates of flap complications. Again, remember that you can reduce your risk of LASIK complications by choosing a reputable, experienced eye surgeon.
Some problems associated with LASIK flap complications include:
Irregular astigmatism can result from a less than smooth corneal surface. Irregular astigmatism also can occur from laser correction that is not centered properly on the eye. Resulting symptoms may include double vision (diplopia) or "ghost images." In these cases, the eye may need re-treatment or an enhancement.
Diffuse Lamellar Keratitis (DLK), nicknamed "Sands of the Sahara," is inflammation under the LASIK flap that may have several causes. Some inflammation of the cornea after LASIK surgery is normal. But if it is uncontrolled, as in DLK, it can interfere with healing and cause vision loss. If DLK occurs, it usually responds to therapies such as antibiotics and topical steroids. The flap also might need to be lifted and rinsed for removal of inflammatory cells and to prevent tissue damage.
Keratectasia or keratoconus is bulging of the eye's surface that can result from a flap that is cut too deeply, when too much tissue is removed from the cornea during LASIK or when the cornea initially was weakened as evidenced from cornea topography mapping prior to LASIK. Resulting distorted vision likely cannot be corrected with laser enhancement, and gas permeable contact lenses or corneal implants (Intacs) may be prescribed to hold the cornea in place.
A promising new treatment for keratectasia (also called "ectasia") is corneal collagen cross-linking with riboflavin (C3-R). In this non-invasive procedure, eye drops containing riboflavin (vitamin B2) are placed on the cornea and then are activated with ultraviolet (UV) light. This strengthens the links between the collagen connective tissue fibers within the cornea to halt the bulging of the eye's surface.
In some cases, it may be possible to perform a laser enhancement of the eye after collagen cross-linking treatment to restore vision loss caused by post-LASIK ectasia or keratoconus.
LASIK Complications: How They Affect You and How They Are Treated
Complications
Symptoms
Treatments
Incomplete corrections (undercorrection, overcorrection, residual astigmatism) or regression of effect
Blurry, less-than-perfect vision
Glasses or contact lenses; eyedrops; re-treatment with laser
Decentered ablations
Visual aberrations*
Eyedrops; re-treatment with laser
Oversize pupils (pupils wider than treatment zone)
Visual aberrations*
Eyedrops; re-treatment with laser
Haze
Visual aberrations*
Eyedrops; re-treatment with laser
Irregular flap (folds, wrinkles, striae)
Visual aberrations*
Surgical correction; second laser procedure
Dry eye
Dry, itchy or scratchy eyes, often with redness and sense of foreign object in eye, and sometimes pain
Prescription dry eye medication; artificial tears; punctal occlusion (blockage of tear ducts in order to retain tear film on eye), oral flaxseed oil
Diffuse lamellar keratitis (eye inflammation)
Visual aberrations*
Eyedrops; surgical rinsing of cells
Epithelial ingrowth
Visual aberrations*
Surgical removal of epithelium
Infection
Redness, oozing of eyes, sometimes pain
Eyedrops; oral medications
*Visual aberrations include symptoms such as glare, double vision, ghosting, halos, starbursts, loss of contrast sensitivity, and problems with low-light or night vision. Not all patients experience all symptoms, and some patients with these complications experience no symptoms and require no treatment. [See also: Higher-Order Aberrations.] Chart created by Keith Croes and reviewed by Brian Boxer Wachler, MD.
Other, more commonly reported complications that can result from LASIK eye surgery include:
Dry Eye After LASIK: Almost half of all patients report problems with dry eyes in the first six months following LASIK, according to the April 2006 issue of American Journal of Ophthalmology. These complaints appear related to reduced sensitivity of the eye's surface immediately following the procedure. If you have this problem, temporary remedies such as artificial tears or prescription dry eye medication may be needed along with oral flaxseed oil capsules. After about six months to a year, however, most dry eye complaints disappear when healing of the eye is complete. People who already have severe dry eye usually are eliminated as LASIK candidates.
Significant Undercorrection, Overcorrection, or Regression: This means that your outcome is less than optimal and makes it difficult to function in certain situations. There are various reasons for these problems. In many cases, the cause is simply that a patient's eyes did not respond to laser eye surgery in a predictable fashion. But it's also possible that results are related to an inaccurate diagnosis or incorrect settings programmed into software guiding the laser during eye surgery. Regression from "over-healing" occurs when your eyesight is optimal at first, but then begins to deteriorate over time. In most cases, a significant undercorrection or regression can be treated with additional laser vision correction or other refractive surgery methods such as conductive keratoplasty, once it is certain that the refractive error is stable.
Eye Infection or Irritation: These problems are rare and may require treatment with eye drops containing antibiotics or anti-inflammatory medication such as steroids. When bacterial infection occurs after LASIK, it appears to be related increasingly to an antibiotic-resistant form of Staphylococcus aureus. Survey results indicating a growing problem with this type of infection were reported at the 2008 annual meeting of ASCRS. LASIK surgeons also reported that infections occurred more frequently with surface ablations such as PRK and when bladed instruments called microkeratomes are used to create the flap during LASIK surgery. ASCRS reports indicate that flaps that are lifted and replaced on the eye during LASIK, serving as a type of "natural" bandage, appear to create a more sterile surgical environment than PRK and other surface ablation procedures.
A Note About Presbyopia and Cataracts
If you are under age 40 when you undergo LASIK, remember that your reading vision naturally will change when you are older, due to presbyopia. Normal age-related changes in the flexibility of your eye's natural lens will cause you to slowly lose the ability to focus at closer distances. If you are nearsighted, you will lose your near vision when you wear your glasses but may be able to read comfortably by removing them.
Presbyopia is not caused by LASIK and will occur whether or not you have refractive surgery. You also might want to review options for eye surgery to correct presbyopia.
As you grow older, you also might develop cataracts. Again, this problem is unrelated to LASIK surgery. If you develop cataracts after LASIK, this is purely coincidental. Having LASIK will not limit your ability to have cataract surgery in the future, if that becomes necessary
How to Have an Organized Kitchen
The best way to organize your kitchen is to put your items where they will be used the most. The less distance you have to travel to get what you need the more efficient you are in your kitchen. Here is a simple way to give yourself an organized area in your kitchen for both your baking and cooking needs
Step 1
So the idea here is to eliminate the time you spend wasting getting together all the things you need to bake or cook. You group the items together in one area so when you are working you can have what you need on hand and keep your mess confined to one area as well.
Step 2
The first step is to evaluate where you do most of your cooking and where you do your baking. If you are like me you do your cooking near the stove top and your baking near the oven.
Step 3
Once you have identified where you do your work for each task set aside that area for the tools you need for that task. For instance if you usually do your baking on the counter top near your oven then those cabinets and drawers should be used for all your baking tools. This would include your cake, cupcake, and loaf pans, cookie cutters, cake decorating kits, beaters, measuring cups etc. Put all the tools that you use primarily for baking in these drawers and cabinet and when you have baking to do this is where you begin your work.
Step 4
Once your baking section is setup then you can move onto your cooking section. This area would include your casserole dishes, spatulas, meat thermometer, liquid measuring cups and any other tools you use primarily for cooking. This area can also include your spices. I find that a drawer is the best place for most of my regular spices because I can see what I have and am not digging behind others to find the one I need.
Step 5
Once you have set up your two zones. There will be some cross overs for instance, most people use measuring cups for both cooking and baking. There are two ways to handle this one you can have two sets one for each section or you have to decide where those items will go and make sure it is somewhere in the middle. I had two sets once I pulled all my stuff out of my drawers so I keep one in each area of my kitchen.
Step 6
Now you have two distinct areas in your kitchen for your two main task and it will be easier to find and faster to get your meals prepared because you will no longer be looking through your cabinets and drawers for all the supplies you need. Happy Cooking!
Step 1
So the idea here is to eliminate the time you spend wasting getting together all the things you need to bake or cook. You group the items together in one area so when you are working you can have what you need on hand and keep your mess confined to one area as well.
Step 2
The first step is to evaluate where you do most of your cooking and where you do your baking. If you are like me you do your cooking near the stove top and your baking near the oven.
Step 3
Once you have identified where you do your work for each task set aside that area for the tools you need for that task. For instance if you usually do your baking on the counter top near your oven then those cabinets and drawers should be used for all your baking tools. This would include your cake, cupcake, and loaf pans, cookie cutters, cake decorating kits, beaters, measuring cups etc. Put all the tools that you use primarily for baking in these drawers and cabinet and when you have baking to do this is where you begin your work.
Step 4
Once your baking section is setup then you can move onto your cooking section. This area would include your casserole dishes, spatulas, meat thermometer, liquid measuring cups and any other tools you use primarily for cooking. This area can also include your spices. I find that a drawer is the best place for most of my regular spices because I can see what I have and am not digging behind others to find the one I need.
Step 5
Once you have set up your two zones. There will be some cross overs for instance, most people use measuring cups for both cooking and baking. There are two ways to handle this one you can have two sets one for each section or you have to decide where those items will go and make sure it is somewhere in the middle. I had two sets once I pulled all my stuff out of my drawers so I keep one in each area of my kitchen.
Step 6
Now you have two distinct areas in your kitchen for your two main task and it will be easier to find and faster to get your meals prepared because you will no longer be looking through your cabinets and drawers for all the supplies you need. Happy Cooking!
How To Make Good Biscuits Tips
I went to the internet to check through how to improve my biscuits and wanted to share with you guys on the following.
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How to Make Good Biscuits
What is a good biscuit? In the American sense of the word, biscuit is a shortened bread, to be eaten hot. It should be baked in small portions, delicately browned, but not hardened on the outside, moist and light from the steam so suddenly developed in it from the quick baking, rather thick with a very soft, fine-grained crumb, but flaky and tender rather than porous and elastic like bread. Many cooks fail to realize this difference and vigorously knead their biscuit, not knowing that as soon as flour is wet it develops a sticky, elastic substance called gluten, which becomes more rubbery the more it is worked. For the same reason that one does knead bread, one does not knead biscuit.
The secret of baking good biscuit is to have the dough as soft as one can handle it, but not to handle it a bit more than is necessary after the wetting has been added to the flour, and to bake it in a quick oven.
Cookery experts have experimented with every possible variation of the cookery recipe until they have not only established the standard recipe; but have ascertained exactly the result of varying it in any given detail. But it is not enough to follow the standard rule; there is something in one's technique. Experience proves that a cup of flour will make five large fat biscuits, or ten or twelve smaller ones, but that the smaller ones are a little superior; that a proper degree of lightness is secured by two teaspoons of baking powder to the cup of flour; that half a teaspoon of salt will take away the flat taste of the dough without giving an appreciably salty flavor; that there should be about half as much wetting as flour; that two tablespoons of fat is enough shortening to make a tender, flaky crust, but that more makes it too rich, more like pie crust, and therefore apt to give a greasy, heavy crumb.
One's results depend largely upon the way the fat is mixed with the flour, the quantity of the liquid added and the method of adding it, and the subsequent handling of the dough. Whether one chops the fat into the flour with knives, feeling that this is cleanlier than to rub it in with the hands, or that the heat of the hands tends to make the mixture waxy, or whether one feels confident in the cleanliness of one's hands and finds that if the materials are properly cold one can be surer of the right results when guided by the sense of touch, the point to be aimed at is a mixture in which there are no fatty lumps and no unshortened flour; it should feel slightly mealy.
Whether the liquid to be added is water or milk, it should be cold, and the quantity should be half that of the flour used. This makes a dough too soft to handle. Stir it lightly just enough to wet the flour, and turn it out on a thickly floured board. By this method the dough should all come away clean from the pan. The top will be too soft and sticky to touch, but if you sprinkle it thickly with flour you can easily flatten it out with the hand or spatula and shape it up so it can be cut advantageously. The inside is still to wet to handle, so dip the cutter in flour to keep the dough from sticking to it. You may have to use a spatula to transfer the biscuits to the pan.
Make 2-inch rounds, and put them in a pan which has been dusted with flour to prevent sticking. Never grease the pan, nor the outside of the biscuit.
Lay the rounds so that they do not crowd each other too much, or as they rise they will become misshapen and too thick. Experiment has shown that they are much better when cooked twelve or fifteen minutes in the top of a quick oven, than twenty or thirty minutes lower down in a slow oven. Overcooking does not produce the ideal biscuit.
Does the kind of shortening matter? Not greatly, though, of course, butter is more expensive than other fats, and gives a characteristic yellow color, as well as a characteristic flavor which many people think too pronounced for a hot bread to be eaten with butter. Many cooking fats and compounds contain cottonseed oil, which in its changed form is not in the least objectionable, but unchanged cottonseed oil gives off a strong, offensive odor and is therefore highly objectionable. If you use sour cream, of course, use less shortening — how much less depends on the quantity and richness of the cream.
Of course, the measurements given here mean precise, level measurements. Accuracy in biscuit making, as in all other forms of cookery, makes all the difference between the unreliable products, the occasional brilliant successes and the frequent failures; of the hit-and-miss cook, and the consistently good products of the cook who knows not only the rule, but the principle by which she works. To summarize:
1 cup flour,
2 teaspoons baking powder,
1/2 teaspoon salt,
2 tablespoons fat,
1/2 cup liquid
with as much more flour as may be necessary to handle the sticky dough. Vary this recipe sometimes for specially dainty occasions, by pressing down into the top of each biscuit a cube of sugar dipped in orange juice. But remember that the melting sugar makes the tops brown more quickly than they ordinarily would, so be careful to avoid overcooking. Sometimes a cube of canned pineapple may be substituted for the orange-dipped sugar, or you may find something among your own preserves more to your individual taste. The sugar and juice make a little well of sweetness in the top of the biscuit, and they do not split like ordinary biscuit. Put a little butter on the top, serve very hot and eat with a fork.
----------------
How to Make Good Biscuits
What is a good biscuit? In the American sense of the word, biscuit is a shortened bread, to be eaten hot. It should be baked in small portions, delicately browned, but not hardened on the outside, moist and light from the steam so suddenly developed in it from the quick baking, rather thick with a very soft, fine-grained crumb, but flaky and tender rather than porous and elastic like bread. Many cooks fail to realize this difference and vigorously knead their biscuit, not knowing that as soon as flour is wet it develops a sticky, elastic substance called gluten, which becomes more rubbery the more it is worked. For the same reason that one does knead bread, one does not knead biscuit.
The secret of baking good biscuit is to have the dough as soft as one can handle it, but not to handle it a bit more than is necessary after the wetting has been added to the flour, and to bake it in a quick oven.
Cookery experts have experimented with every possible variation of the cookery recipe until they have not only established the standard recipe; but have ascertained exactly the result of varying it in any given detail. But it is not enough to follow the standard rule; there is something in one's technique. Experience proves that a cup of flour will make five large fat biscuits, or ten or twelve smaller ones, but that the smaller ones are a little superior; that a proper degree of lightness is secured by two teaspoons of baking powder to the cup of flour; that half a teaspoon of salt will take away the flat taste of the dough without giving an appreciably salty flavor; that there should be about half as much wetting as flour; that two tablespoons of fat is enough shortening to make a tender, flaky crust, but that more makes it too rich, more like pie crust, and therefore apt to give a greasy, heavy crumb.
One's results depend largely upon the way the fat is mixed with the flour, the quantity of the liquid added and the method of adding it, and the subsequent handling of the dough. Whether one chops the fat into the flour with knives, feeling that this is cleanlier than to rub it in with the hands, or that the heat of the hands tends to make the mixture waxy, or whether one feels confident in the cleanliness of one's hands and finds that if the materials are properly cold one can be surer of the right results when guided by the sense of touch, the point to be aimed at is a mixture in which there are no fatty lumps and no unshortened flour; it should feel slightly mealy.
Whether the liquid to be added is water or milk, it should be cold, and the quantity should be half that of the flour used. This makes a dough too soft to handle. Stir it lightly just enough to wet the flour, and turn it out on a thickly floured board. By this method the dough should all come away clean from the pan. The top will be too soft and sticky to touch, but if you sprinkle it thickly with flour you can easily flatten it out with the hand or spatula and shape it up so it can be cut advantageously. The inside is still to wet to handle, so dip the cutter in flour to keep the dough from sticking to it. You may have to use a spatula to transfer the biscuits to the pan.
Make 2-inch rounds, and put them in a pan which has been dusted with flour to prevent sticking. Never grease the pan, nor the outside of the biscuit.
Lay the rounds so that they do not crowd each other too much, or as they rise they will become misshapen and too thick. Experiment has shown that they are much better when cooked twelve or fifteen minutes in the top of a quick oven, than twenty or thirty minutes lower down in a slow oven. Overcooking does not produce the ideal biscuit.
Does the kind of shortening matter? Not greatly, though, of course, butter is more expensive than other fats, and gives a characteristic yellow color, as well as a characteristic flavor which many people think too pronounced for a hot bread to be eaten with butter. Many cooking fats and compounds contain cottonseed oil, which in its changed form is not in the least objectionable, but unchanged cottonseed oil gives off a strong, offensive odor and is therefore highly objectionable. If you use sour cream, of course, use less shortening — how much less depends on the quantity and richness of the cream.
Of course, the measurements given here mean precise, level measurements. Accuracy in biscuit making, as in all other forms of cookery, makes all the difference between the unreliable products, the occasional brilliant successes and the frequent failures; of the hit-and-miss cook, and the consistently good products of the cook who knows not only the rule, but the principle by which she works. To summarize:
1 cup flour,
2 teaspoons baking powder,
1/2 teaspoon salt,
2 tablespoons fat,
1/2 cup liquid
with as much more flour as may be necessary to handle the sticky dough. Vary this recipe sometimes for specially dainty occasions, by pressing down into the top of each biscuit a cube of sugar dipped in orange juice. But remember that the melting sugar makes the tops brown more quickly than they ordinarily would, so be careful to avoid overcooking. Sometimes a cube of canned pineapple may be substituted for the orange-dipped sugar, or you may find something among your own preserves more to your individual taste. The sugar and juice make a little well of sweetness in the top of the biscuit, and they do not split like ordinary biscuit. Put a little butter on the top, serve very hot and eat with a fork.
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