How do we react to an illness?

Health is of paramount importance to us and disease is always perceived as a threat to our well being and to our life
.
Heart attack evokes a scare and fear of death.This fear remains even after successful treatment. Not only the patient but his friends and relatives are also shaken.They may consult a cardiologist and make changes in their lifestyle.

Cancer creates a fear of death.It is a sudden news and signals exit from this world in near future.The whole family is shaken. Fortunately many treatments are available now, due to the advances in medical technology. Coping with the long term suffering needs a support system. It is a major setback for the patient which changes his outlook towards life.

A sudden attack of stroke paralyses the patient in every sense. A mighty hand of destiny strikes a powerful blow to his existence. "why me?" is the question that bothers him. 
It is an ordeal to remain bed ridden and disabled throughout the life. 





Parkinson's disease evokes self pity. Patient feels trapped and helpless. He undergoes a lot of suffering and leads a very restricted life till the end.It is an agony. His family also suffers along with him.  He is haunted with the thoughts "Why me?" "Is it my past karma?"  What have I done? 

Tuberculosis causes a stigma and also the long term suffering due to the adverse effects of the medicines.He would not like others to know about it.

In most of these diseases, people turn to spirituality, perform rituals, visit the family deity. Also they may consult an astrologer, who reassures them and asks to perform some rituals (at a reasonable cost) 


What about diabetes?




Diabetes does not create a panic or a threat to life. The literature mentions that he suffers from depression but soon recovers and become normal.

There is no "why me?" feeling in diabetes because he is not the only one. Many of his friends and relatives have it. It has become so common in society that there is no shock or a surprise or a stigma (It may add to the status)

He reacts in different ways:

"So it has come, I was expecting it",

"No wonder, it is in our family"

"Now I should not eat sweets". 

"I feel nice ,no symptoms"

He does not feel the burden of the problem (which he should be feeling) There are ups and downs in the blood sugar, but he is cool. He knows various complications of diabetes, but is indifferent. His family is also cool. 

I have not seen a 'worried' diabetic yet,. 

Who is afraid of diabetes?

Can you stop medicines for high blood pressure?

A lady patient came for consultation. I saw her file and the list of medicines she is taking. There were in all 11 medicines. Two of them for high blood pressure.

She was taking these anti hypertensives for nearly 20 years,
and regularly visiting the doctor who prescribed them.
At every follow up visit that doctor said only one word "continue"

I took her blood pressure. It was 130/ 70.
I told her to stop these two medicines for some time. She refused. "How can I stop?  it may increase" 

I explained to her that blood pressure will not rise suddenly. It may take at least 3 weeks to rise. You can monitor it at home with the instrument once in a week. If there is a rise within 3 weeks we can restart the treatment.

The arm should be resting on the pillow and cuff should be at the level of the heart 

The lady agreed and discontinued her two medicines. She monitored her blood pressure every week for the next 4 weeks. The blood pressure did not rise.

She felt confident but still was in doubt " what if it increases after 3 moths or 6 months?"  

I said " Please continue to monitor once a week. No need to worry"
. 
Six months have passed and her pressure is still normal

P.S.:

Millions of patients are taking treatment for many years. Doctors are not interested in a review in their busy practice.

Patients are also not keen for a review because they have been told:

"Treatment of high blood pressure is life long"

Not necessarily. 

Dangerous slimming pills sold on-line

A braking news:

A lady working as a trainer in a gym at Thane, Mumbai purchased a banned drug online which is a slimming pill and died within hours due to the toxicity of the drug.

The name of the drug is dinitrophenol 

It was originally used as a herbicide and fungicide
Later its slimming action was known and it was used by body builders for weight loss.

It has been banned since 1938 .

How it works?

• It accelerates the metabolic rate and subsequent weight loss. The weight loss is due to burning fats and carbohydrates and the energy released is converted into heat.
• The death occurs within 12 hours due to a extreme rise in body temperature,beyond limits,drastically high rise in heart rate and blood pressure.

Legal status

• Availability of banned drugs online is a big concern

• Dangerous drugs are being sold online under different names and sounding as Ayurvedic drugs (meaning indigenous and safe)

• FDA has taken action against 62 portals for selling banned drugs

P.S.

• This shows our desperate mind and the need to become trim and slim in a shortest time.

• When there is such desperate demand to obtain these drugs by any means there will be  a supply 

• Who gave her this drug and how this banned drug was made available is not known yet. 

Cannabis as a recreational drug

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Globally, marijuana is the most commonly used illicit drug. It is classified as a Schedule 1 controlled substance, It is a mood-altering drug

It's official now:

Many states in US have allowed the sale of cannabis for recreational use, Cannabis is a popular recreational drug around the world, only behind alcohol,caffeine and tobacco. 






How do you feel?
 .

• light headedness,
• feeling of relaxation,
• increased appetite, 
• reduced blood pressure.

 How do you define "Recreational use?" . .

• It only happens in social situations,like smoking a cigarette or  having a glass of beer.

• It is not "needed" to help the person relax or to get through their day.

• You do not use it to stimulate appetite or sex or bowel movement.

• They are not addicted and don't have other problems associated with drug use.

Caution:

Marijuana is not harmless. It can trigger a mental illness.  Recreational use can become a compulsive use in stressful life situations.

What compels the person to take cannabis? 

Breaking of families and marriages creates a feeling of isolation. Each one is for himself where there are no easy answers..The person feels incapable to face the hostile world by himself. Addiction to cannabis give him the peace and love and the ability to face the world.

Cannabis in India

In Bangalore, Vedi wellness Centre has opened on 1st Feb 2020. It is India's first medical cannabis clinic which offers cannabis based medicines.

These medicines are used for for depression, insomnia, neuropathic pain.(not for recreation)

Cannabis in homeopathy:

Homeopathic cannabis is made by serial dilusions in different potencies. It is safe and there is no risk of addiction

The feeling of being incapable of facing the hostile world needs cannabis.

Diabetics should check their vitamin B12 levels

Most diabetic patients are above 60 and also taking metformin, both of which are associated with vitamin B12 deficiency.



This affects the nerves of hands and legs and there is numbness, tingling,burning sensations in hands and legs (peripheral neuropathy)




This is treated by taking the injections of vitamin B12 and folic acid

Inj. VITCOFOL 10 ml vial

2ml per injection.given once a week

Total 5 injections

These injections should be given in the buttock

Vitamin D in diabetes

Most diabetics have a deficiency of vitamin D 

This leads to 

• High Hb A1c levels (uncontrolled diabetes)

• Albumin in urine (nephropathy)

Every diabetic should have a normal level of vitamin D( 30 ng /mL)

• There is no vitamin D in foods. Only a limited amount in some foods

• If you expose to sunlight for 90 minutes per day then you get vitamin D, just enough for the day. 

• Only reliable way of getting it through the supplements which are available as sachet or tablets

Diabetics suffer from depression

Depression is both a cause and effect of diabetes

A study of 272 diabetic patients showed that 60% had depression


Following features were seen

• Physical inactivity
• smoking 
• Alcohol intake
• Albumin in urine

• Poor control of diabetes
• poor quality of life
• Neglect of proper diet

P.S.

• Depression remains unrecognized and hence untreated
• Diabetics will not take professional help
• They are not proactive  
• They do not complain 
• They just accept the problem and do nothing about it.

Diabetics should monitor their blood pressure

100 diabetics who had normal blood pressure were studied.
These patients had fluctuations in the blood pressure which are as follows

• Early morning rise
• Night time surge (Nocturnal hypertension)
• Fluctuations during the 24 hr period

Such variations were associated with

• Albumin in urine
• High HbA1C (Average blood sugar during the last 3 months

Do they need medicines to lower the blood pressure?
No. 
These patients are not hypertensives.


But they should monitor their blood pressure at home 


Ambulatory blood pressure monitoring:

Use the same arm. Place the cuff on bare skin, not over clothing. 

Rest your arm,on a table raised to the level of your heart. If needed, place a pillow under your arm to elevate it to the level of heart

P.S.

These variations in B.P. will stop when we control our diabetes.

• Reduce weight and abdominal circumference
• Reduce calories
• Stop eating out

• 
  

Pear shaped woman & Apple shaped woman

A woman who has abdominal circumference more than 80 cm has central (abdominal) obesity.  Her body weight may be in normal range.

Pear shaped woman:

• Fat is deposited in buttocks and hips
• No deposition of fat around abdomen
• Abdominal circumference at the level of navel is 80 cm or less
• No risk of diabetes or heart disease

Apple shaped woman:

• Larger waist and carry a lot of weight around the abdomen
• Abdominal circumference is much more than 80 cm (it is between 95 to 100 cms)
• More risk of diabetes and heart disease

Pear-shaped women are healthier than Apple-shaped women 

Waist -to-hip ratio:

Measure around the widest part of your hip and the narrowest part of your waist (just above the navel)

Divide your waist measurement by your hip measurement

Waist -to- hip ratio should be less than 0.85 

The ratio greater than 0.85 is a risk factor for diabetes and hear disease.
Apple shaped women have higher waist to hip ratio

More and more women are becoming Apple shaped with a high waist- to- hip ratio and are suffering from diabetes or heart attack

 .P.S.

Women are not aware of abdominal obesity.

Even if they are told about it they may not take it seriously

It needs great efforts and a very disciplined lifestyle.

Average woman will just accept it and do nothing about it

Can we prevent dementia in old age?

Dementia is a condition characterized by a decline in memory, language, problem-solving and other thinking skills 

It affects a person's ability to perform everyday activities. Memory loss is an example. Alzheimer's is the most common cause of dementia. 

Dementia is seen in old age but the process is going on in the brain for the past 15 to 20 years.

 common early symptoms::

•  memory problems,(for the recent events) 
•  increasing confusion.
•  reduced concentration.

It is possible to prevent this irreversible problem, 
It is difficult but not impossible.

How is your cardiovascular health when you become 50 years old.?
If you rectify these risk factors you can minimize the risk of dementia.

what is the action plan?

• Stop smoking from today,(if you are a smoker)
• Improve you diet:.

      fruits and vegetables  
      whole wheat bread or roti
      Basmati rice (refer to the blog on basmati rice)
      Chole, rajma ,Mung 
      Restrict the cooking oil to half liter per month 

• Regular physical exercise 
• optimal body weight
• Normal blood sugar (without anti diabetic drugs)
• Normal blood cholesterol (without statins)
• Blood pressure within normal range 

   Stop eating out (birthdays,marriages,get together etc)  

P.S.

• How simple is it and how difficult it is?

• If there were medicines to rectify these risk factors, you would not mind taking them.

• Unfortunately you have to make efforts and lead a disciplined lifestyle for many many years.

• Is it possible? 

Do it as much as you can.

Something is better than nothing

Brown rice & white rice

 

 The outermost layer of rice, called the hull, is removed to make brown rice. 

All white rice starts out as brown rice. A milling process removes the rice’s husk, bran, and germ. This process increases white rice’s shelf life but removes much of its nutrition, including fiber, vitamins, and minerals.

Brown rice is a whole grain. It contains more overall nutrition than the white rice and reduces the risk of heart disease and diabetes. It reduces the level of HbA1c and bad cholesterol

Brown rice is generally higher in fiber than white rice.which has many health benefits

• feel fuller faster, which can aid in weight management
• lowers cholesterol 
• control blood sugar 
• reduced risk of heart disease
• nourish gut bacteria

White rice has high GI (72)
Brown rice has low GI (50)

Risks:

• Rice crop is known to be contaminated with arsenic, whether white, brown, organic, or conventional. 

FDATrusted Source issued a statement discouraging pregnant women from using rice or rice cereals as the primary grain staple due to arsenic contamination. 

Bottom line:

• White rice has very less arsenic, since the bran layer has been totally removed.

• Brown rice is more nutritious but contains arsenic. 

• If the intake is limited then brown rice is preferred.

• One should limit the intake of rice and eat a variety of cereals

• Basmati rice has the least amount of arsenic and all the vitamins and the minerals