URINARY Incontinence

One of the reasons that keeps some women away from outdoor activities and they find embarassing to discuss is urinary incontinence. Although not threatening to life, this disorder caused by lack of control to hold back urine, often spoils the quality and makes life miserable.

Incontinence of urine is quite common; around 10% of adult women suffer from this disorder. The typical sufferer is a woman above 40, overweight and had suffered injury to the pelvic muscles while bearing children. The leakage of urine into undergarments or clothes is often intermittent during fits of coughing, sneezing or while lifting heavy objects. It sometimes progresses to a state of constant dribbling.

The consequences are a feeling of being “soiled” or a constant worry of it. Often the smell of urine can be a source of embarassment in social gatherings that strong perfumes are unable to cover. She starts shying away from group activities, prefers to remain isolated, begins to lose self-esteem and often becomes depressed. The sense of leakage and “soiling” leads them to avoid sex.

Use of pads or STs helps provide temporary respite during travel and when gong out for long periods. If needed to be used regularly however, it can be expensive. Further, the constant feeling of being “wrapped up” can hardly provided a sense of freedom or confidence in close interpersonal physical relationships, and one starts getting “bound up” in spirits as well.

If one can come out of the initial inhibition and seek help, this disorder often responds well to treatment. The 1^st step is to strengthen the muscles of the pelvis and the sphincter, by exercises that a gynecologist or urologist could teach. The weak muscular sphincter near the bladder neck gets strenghthened and control returns. Medications to increase the tone of these muscles can also help provide early relief especially while while waiting for the muscles to regain strength through exercise.

Few women with persistent incontinence require surgery. The pelvic muscles are tightened and a sling  passed around the urethra to restore control. This surgery is not risky, but needs to be performed by an expert for good results.

Incontinence does occur in males as well, but is less common. It usually follows surgery for the prostate. Sometimes it occurs when diabetes, surgery or neurological diseases damage nerves that convey bladder sensation or impulses to sphincter muscles.

The satisfaction of feeling the fullness of the bladder, and keeping one’s control on when and where to void urine is something we take for granted. Incontinence is a disruption of this fine control, that disrupts our social lives. Help is available as long as one is willing to overcome the initial embarassment and seek it!

 As published in HT City ( Hindustan Times) dated 21 march, 2010.

A Gift of Life!

Madhu is in the 5^th year of her new life. She had alsmost reached her end because of her failing liver, when on 14^th February 2004, a new liver arrived in Lucknow almost by miracle.

She had been a healthy homemaker and mother till 1994 when she had an attack of jaundice. Unlike the common ones that pass away on their own, this episode, was persistent. One doctor after another and with one herbal tonic to be replaced by another, she finally reached the SGPGI. Tests revealed that her chronic liver ailment was not due to the common infective viruses B or C but due to a rare condition called autoimmune hepatitis, a condition in which the body’s defending cells and immune system start attacking its own organs, in her case, her liver.

Autoimmune hepatitis is somewhat rare: it accounts for 2% of all prolonged cases of hepatitis or liver cirrhosis. It affects women 5 times more often than men, and needs awareness for timely diagnosis. If detected on time, the disease can be controlled with immunosuppressants like corticosteroids.

Madhu had reached us somewhat late and a portion of her liver had already permanently damaged. She was however treated with immunosppressants to preserve the viable portion of her liver. She had her ups and downs, but remnained largely well for almost 8 years. By 2002, her liver had become weak; she had water in her abdomen, swelling of her feet and side effects of the medicines as well. It became obvious that only a liver transplantation could get her back to life and health at that stage.

Her husband, a bank emplyee, tried all he could; he consulted various liver transplant centers in India, offered to donate a part of his own liver and took large loans to provide for the increasing costs of her treatment. Unfortunately he was found to have fatty liver that was unsuiatble for donation, and his abdomen was closed. With that almost all hope diasappeared, as there were no suiatable relative in Madhu’s home who could donate her a part of his liver.

On 13^th March 2004, a man who was on a ventilator in one of the hospitals in Delhi following an accident, was pronounced brain-dead. Under such trying circumstances, his relatives gallantly agreed to his liver being extracted for donation to a needy person. Dr Peush Sahni from AIIMS extracted the liver,  and flew into Lucknow on 14^th morning. Madhu was taken into the operation theatre and Dr Rajan Saxena and Dr Peush transplanted the new liver into Madhu.  That indeed was destiny! The relatives of the donor were magnanimous enough not to seek publicity for saving someone else’s life, and requested anonymity.

Madhu continues to be well 5 years on. Her daughter got married this year.  Madhu and her husband, and 5 more such heroes from Lucknow who have been through liver transplantation, have offered to provide counselling to patients and their relatives facing similar challenges, a service which we plan to provide through the Liver Foundation of UP that kicks off on 19^th of this month.

As published in HT City ( Hindustan Times) 

Women's Health Matters

The events around World Woman’s Day last week brought out the grim state of health and power women enjoy in our society yet again. Women have probably realized by now that their dependence on “chivalrous” and “caring” male partners over history has not done them much good, and have finally decided to take up their cudgel, at least in politics.

Medical research has shown that women’s health matters to society. Weak anemic mothers with soft fragile bones produce weak low birth-weight babies, even male ones. And the short-sightedness of feeding iron and calcium to our women only during pregnancy while neglecting them the rest of their lives, can’t make them robust quickly enough to bring forth a healthy next gen. Kerala is the state that has shown by example, how educating and empowering women can make a strong and healthy society.

I wonder whether Aishwariya Rai Bacchan who adorns the Wikipedia page on ‘Women in India’, also personify health and power, as she does beauty (often skin deep and short lasting) and charm (that males like to rate women on!). A recent survey (NFHS-3) found 3 of every 4 pregnant Indian women to be anemic (deficient in iron), and a quarter to be osteoporotic (deficient in calcium and vitamin D). Women in Uttar Pradesh have a shorter life expectancy than males, while those in Kerala live 6 years longer than them. Women are much more prone to depression and physical abuse. They suffer from cancers of the cervix and breast, and do not have adequate organized women-manned health check up facilities for their detection and treatment.

Women have been a vulnerable lot all along; they had to burn themselves at the pyre of their dead husbands, hide their faces from the sun and society, serve as Devdasis according to the Almighty’s wish conveyed to them through male priests, and subjected to trafficking and exploitation. Very few men, like Ram Mohun Roy, have had the courage to stand up for them!

In many places and many homes, disrimination against women starts even before they are born. The present technology-aided practice of female feticide continues in several states, with an excess of deprived hungry men destroying the subtle balance of society with crimes against women. The girl child is discriminated in many homes with regard to food, education, property and rights.

What surprises me though is that traumatized embarassed young women who have borne daughters are more scared of their mothers-in-law, whom they blame for their plight, than their husbands! It is imaginable what the elder woman might have gone through in her “bahu” days in the same home, but what baffles me is how she turns colour and becomes the offender on becoming “saas”, and bullies her helpless “bahu”, disregarding all the resolves she made 20 years ago! In fact, she often perpetuates the practice of dowry that prevails unabated despite the strict laws on paper.

Educating our girl child and empowering them can work wonders in UP too, provided of course our “saas” undergoes a change of heart and permits it! 

As published in HT City, Hindusatn Times (Lucknow edition) dated 14th March, 2010

Battling Exam Fever !

The two words that are being hurled frequently at exam goers these days are “Concentrate” and “Relax”, both difficult to practice, yet being vital determinants of a good examination performance.

“Concentration” is the proverbial hippopotomus, easy to recognize, but not always easy to understand and master. Students often remain buried in their books for long hours, with little going into the heads or staying there! Remember, concentrating is about focussing the mind, not merely looking into books or repeated reading.

This simple 2-minute technique helps improve cncentraion.

Close your eyes and visualize the blue sky in your mind for just 2 minutes. Every time a passing cloud comes between you and the sky, consciously ignore it, and bring your focus back to the blue sky that lies beyond the cloud. Hold your mind in control there for just 2 minutes and don’t let it waver. It sounds simple but may take time to master! If you are able to do it, you will probably be doing very well in the exam as you have good mind control. Repeat this 5 -10 times a day. The blue sky is the information that you need to grasp from the books, and the clouds are the distractions such as fear of failure, anxiety, events going around you, that block your concentration. If you fancy an object or a picture of a deity, instead of the sky, suit yourself. The method and the outcome will remain the same.

The next thing to remember is that most exams test your active memory, not your passive one. Hence, repeatedly going over the same pages may not be enough. I remember a college friend who used to spend long hours before exams lying in bed looking at the ceiling, training his mind to recall all the points on each topic, drawing diagrams and labelling them neatly, all in his mind! He could reproduce them accuratey on the answer paper as well, and is now a celebrated cardiologist in San Francisco.

“Concentration” and “relaxation”  sound incompatible as studies have shown that  blood pressure rises when a person does mental maths. Nevertheless, one can learn to destress while concentrating. Soothing background music works with many. You could also consciously relax the muscles of your face, unclench your fists, wet your mouth with saliva, apply gentle pressure on your eyeballs or take a few slow deep pranayam-style breaths while studying or writing the paper.

Packing your pen kit and admit card, and sleeping atleast 6 hours the night before are of proven value. A breakfast is a “must” as it ensures uninterrupted supply of glucose to the brain during the exam.

 To nurture a feeling of curiosity or adventure about what lies ahead in life can be helpful. I recall how disappointed I had felt when I failed to get into the IIT. Now, as I tend to the ailing and  get lots of blessings in return , and as I write this column, I realize that God had dened me my IIT wish because he had a more grandiose plan for me. Find out what life has in store for you beyound this exam!

“Concentration” is the proverbial hippopotomus, easy to recognize, but not always easy to understand and master. Students often remain buried in their books for long hours, with little going into the heads or staying there! Remember, concentrating is about focussing the mind, not merely looking into books or repeated reading.

This simple 2-minute technique helps improve cncentraion.

Close your eyes and visualize the blue sky in your mind for just 2 minutes. Every time a passing cloud comes between you and the sky, consciously ignore it, and bring your focus back to the blue sky that lies beyond the cloud. Hold your mind in control there for just 2 minutes and don’t let it waver. It sounds simple but may take time to master! If you are able to do it, you will probably be doing very well in the exam as you have good mind control. Repeat this 5 -10 times a day. The blue sky is the information that you need to grasp from the books, and the clouds are the distractions such as fear of failure, anxiety, events going around you, that block your concentration. If you fancy an object or a picture of a deity, instead of the sky, suit yourself. The method and the outcome will remain the same.

The next thing to remember is that most exams test your active memory, not your passive one. Hence, repeatedly going over the same pages may not be enough. I remember a college friend who used to spend long hours before exams lying in bed looking at the ceiling, training his mind to recall all the points on each topic, drawing diagrams and labelling them neatly, all in his mind! He could reproduce them accuratey on the answer paper as well, and is now a celebrated cardiologist in San Francisco.

“Concentration” and “relaxation”  sound incompatible as studies have shown that  blood pressure rises when a person does mental maths. Nevertheless, one can learn to destress while concentrating. Soothing background music works with many. You could also consciously relax the muscles of your face, unclench your fists, wet your mouth with saliva, apply gentle pressure on your eyeballs or take a few slow deep pranayam-style breaths while studying or writing the paper.

Packing your pen kit and admit card, and sleeping atleast 6 hours the night before are of proven value. A breakfast is a “must” as it ensures uninterrupted supply of glucose to the brain during the exam.

 To nurture a feeling of curiosity or adventure about what lies ahead in life can be helpful. I recall how disappointed I had felt when I failed to get into the IIT. Now, as I tend to the ailing and  get lots of blessings in return , and as I write this column, I realize that God had dened me my IIT wish because he had a more grandiose plan for me. Find out what life has in store for you beyound this exam!

Published in HT City Hindustan Times (Lucknow edition) dated 07 March,2010. 

HOLI KE RANG

Eye injuries are a common hazard during Holi, and like other injuries during this festival, is on the rise. Water-filled balloons directly hitting the eye cause the majority of them. Abraisions due to sand or mica that are present in “abir” or “gulal” getting into the eye, or to splashing of toxic colours is another cause; they can lead to grittiness, pain, temporay loss of vision, and occasionally, even permanent blindness.

The other common health hazard during this festival is to the skin and hair. A fact sheet published by a Delhi based organization, Toxics Link, revealed alarming facts about the colours used for playing Holi.

They contain toxic chemicals such as the black coloured lead oxide which can result in kidney failure, the silver paint coloured aluminium bromide and the red coloured mercury sulphate that are carcinogenic, the blue coloured prussian blue and the green coloured copper sulphate that cause contact dermatitis, eye allergy and puffiness. Unsafe Holi players use gutter water, grease, tar and engine oil that aggravate the health hazards further. Strong colours such as gentian violet penetartes deep into the skin, and are difficult to wash away with soap and water; skin abrasions, dermatitis and skin discolorations often follow.

Herbal colours, on the other hand are much safer though slightly more expensive. They are made from petals of flowers like rose, hibiscus or marigold and from other natural sources such as turmeric, henna and spinach. They are not only non-toxic, but smell good, and add the “pleasant and healthy” colourful factor that Holi is thought to have had in epic times.

The following tips could help you enjoy Holi better:

1.Make sure your face is well creamed before you start playing Holi.

2.If you expect to be out in the sun for long, apply a sunscreen on the exposed parts of your body.

3.Apply oil (coconut, olive, or mustard) liberally on your scalp and body, so that colour does not stick and can be washed off easily. Apply Vaseline liberally on the nails.

4.Protect your eyes by wearing sunglasses; preferrably plastic ones can be helpful. Make sure you tightly shut your eyes and mouth when friends apply colour to your face.

5.Wear full-sleeved shirts and full pants.

6.Use natural or herbal colours. You could be the trendsetter and offer some to those who come to apply colours on you.

7.Be careful with intoxicants (bhang, alcohol) as they increase the risk of getting hurt or injured.
8.While washing, use glycerine based soap and don’t rub too vigorously to get rid of the colors from your scalp and skin. They cause damage and abrasions. If the stains are deep, give them a day or two to come off. Apply a moisturiser immediately after bath on damp skin.

9.Dont play with rowdy strangers, who might be intoxicated.

Remember that Holi is a festival to be enjoyed with family and friends, and playing it gracefully and safely need not detract from the fun and enjoyment. Holi Hai!!!

Published in HT City, Hindustan Times (Lucknow) dated: 1st March,2010