Recognising Stress and Identifying its causes

Medical scientists are beginning to realize that stress may be the underlying cause ofmany disease of the body. While our “gut feeling” had always suggested that , recent observations on disaster-survivors who lost loved ones and had to undergo great hardships to rebuild their lives, provide more compelling evidence. They develop diseases and succumb earlier than those who were spared such misfortune.

With overwork, ambition, insecurity and frustration being so integral to our lives, stress, an old survival response, is turning out to be a modern day killer. While positive stress is indeed necessary to fight and succeed in life, our inability to switch it off when its requirement is over, is burning and exhausting us.

The reason why stress has eluded us so long is because there is no test to detect it. You could, for instance, measure a person’s heart rate or blood pressure, both of which may go up due to stress, but not be able to measure stress itself.

Recognizing Stress

Stress may show itself in different ways. It can manifest physically as headaches, fatigue, weight change, tremors or sexual disturbances, or mentally, as lack ofconcentration, confusion, diminished creativity or impaired judgement. It ofen reveals itself through distrurbances of mood such as irritability, anger, anxiety or depression. Sometimes it emerges as an underlying cause for diseases like high BP, diabetes, peptic ulcer or heart disease.

Women usually recognize stress better and seek help for increasing frequency of migraine attacks or altered moods. Men, usually conditioned from childhood to appear brave, cover up stress or deny it, and often come to medical attention rather late with diseases that result from prolonged stress.

What is Causing Stress?

 The causes are many and vary according to age and sex. The main causes in students usually stem from examinations (the gap between their performance and their parents’ expectations), insecurituy of future, and failed romance. The most common source of stress in women is home and children, while for men it is work and office.

The first step towards overcoming stress is to recognize its symptoms and identify the source that is generating it. Here is a list of common causes from which you can tick the ones that best apply to you:

1.     Office, college or school politics

2.     A feeling of little to no control

3.     Tight deadlines and other time pressures

4.     Job or future insecurity

5.     Insecure or turbulent romantic life

6.     Change in the workplace, college or home

7.     Lack of appreciation from seniors, colleagues or family

8.     Promotional or career hurdles

9.     Seeing others go ahead in life by means you did not adopt

10.  Family stress

1. Children’s performance
2. Spouse’s attitude or habits
3. Parents’s attitude or expectations

If you have been able to recognize stress and identify its causes, you are already half way through to overcoming it.

As published in HT City( Hindustan Times) dated 28 August, 2011.

Health Benefits of keeping Pets

When Neal toddled into our home and hearts four years ago, little did we realize that this cuddly pup was bringing in not just happiness but good health as well.  Indeed medical research shows that an animal companion can beneficially impact physical, social and psychological well-being.

In a workshop on the Health Benefits of Pets convened by the National Institute of Health, USA, researchers shared evidence on how our animal companions make us healthier, not just by wiping off our loneliness and depression but by settling high blood pressures and reducing cholesterol levels too.

Throughout history animals have played a significant role in human customs, legends, and religions, and human- animal relationships have been important to our very survival. In our own time, the great increase in pet ownership in developed countries reflects an often unsatisfied need for intimacy, nurturance, and contact with nature.

The importance of pets was demonstrated in the clinical setting as long back as 1919 when doctors at the St Elizabeth Hospital in Washington DC, USA, first used dog companions to help patients in a mental ward recover from depression. Encouraged by the results, patients suffering from the traumatic experiences of the Second World War were encouraged to keep company of animals to hasten their recovery.

Pets can help patients with heart disease. Relaxation, stress management and life style changes have been shown to reduce the risk of heart ailments and animal companions enhance these benefits. Caressing and cuddling pets can reduce stress levels substantially and bring down heart rates and high blood pressure. Walking dogs is a great exercise, especially when they tug at the leash and make you break into short runs.

Further through their faithful companionship and by promoting psychosocial stability for their owners, they reduce the levels of stress hormones in our body. Results from a study, presented at the conference, found that pet owners survived heart attacks more often than those who did not have such bondings.

Another setting where animal companions have proved to be of great value is for handicapped people confined to the wheel chair or bed. Contrary to the common perception that a pet means additional work and burden to a stressed out family, a companion dog can provide wheel-chair patients with a much greater amount of social stimulation than what human companions, such as parents, spouses, siblings, or therapists can provide. Our loyal Indian ones are not expensive to keep but can effectively lift the spirits of such people and usher in cheer and happiness in these gloomy homes.

Pets, especially dogs, are the most faithful and loving companions that humans can ever hope to have in their lives.They can be a great source of joy and support to us. It is indeed a tragedy of our times that some perceive them as a threat or nuisance.

Neal has not just added years to our lives but life, love and meaning to our years!

As published in HT City( Hindustan Times) dated 21 August, 2011.

The Nawab got it Right!

My cardiologist friends, who look me in my belly and enquire how regular my tennis is going in the monsoon months, are at a loss to explain why the last king of Oudh, Nawab Wajid Ali Shah lived till the age of 64 without  needing their expensive services of coronary angioplasty or a bypass surgery.

The nawab had quite a few patently conspicuous “risk factors”. Pictures show him as being grotesquely obese, and tales of his “nawabi” laziness abound.  He is said to have been so dependent on his servants to help him wear his shoes that he could not waddle out of his palace before the British soldiers arrived, as his servants had fled, and he was shoeless.

Plump lazy people are usually fond of food, as his royal highness was. He is said to have instructed his cooks to change the cooking medium (probably ghee) to fry each side of his royal “parathas” separately.

On hearing this tale, I got the uncanny feeling that his cardiologists had intuitively tipped the nawab that reheating of cooking medium could be harmful to his heart. How else could he, in the 18^th century, possibly know that oils and fats which exist in their cis- chemical form in natural states change to trans- fats when heated repeatedly? Modern cardiologists swear by their dangling stethoscopes, that these trans- fats, regardless of their sources and backgrounds, arise from reheating of oils and are most notorious in clogging arteries of our heart.

This vital health tip somehow got obscured in the next two hundred years till the coronary arteries of Bill Clinton, the smart-figured, energetic American president clogged necessitating two surgeries in 2004 to restore blood flow to the crying muscles of his choking heart. Mind you, he was neither fat nor lazy as the nawab had been.

Mr Clinton’s fondness for food was as legendary as that of the nawab. He admits to gourging passionately on fast food and ham-burgers for most of his pre heart surgery life. Once on an arial survey of a disaster-hit region, he is belived to have seen the Big Mac’s “M” and cheered, “Hey, We will get burgers here!”.

What possibly made all the difference to their hearts was the amount of cis- fats in the ‘parathas’ that the nawab ate and the trans- fats in the chips and burgers the American president consumed. If samosas and jilebees are something you can’t do without, get them from your halwai in the morning when he has started the day with a fresh supply of oil. Come evening, and after several sessions of frying and reheating, the trans- fat content shoots up enormously making them toxic to our hearts.

Home makers who pray for their husbands’ health and logevity would do well to use less quantities of oil, fry shallow rather than deep, and change the oil frequently when frying puris or samosas for their beloved husbands.

As published in HT City(Hindustan Times) dated 14 August, 2011.

Too much fibre can cause Bloating and Gas

“Consuming excess fibre is one of the main reasons for excess gas and bloating”, said  Dr Kok-Ann Gwee, a senior consultant gastroenterologist from Singapore and President of the Asian Neurogastroenterolgy and Motility Asssociation, who was here in India recently. He shared his observations of how 86% of rice-eating Singaporeans were troubled by these symptoms when prescibed 2 spoonfulls of bran, considered a healthy dietary supplement in the West.

Indeed many who decide to turn health freaks, and start binging on sprouts often land up consulting gastroenterologists for symptoms of bloating and belching. Milk, in those with lactose intolerance, often cause the same symptoms as undigested food in the intestines encourage breakdown by the colonizing bacteria, releasing large quantities of CO2, Hydrogen and methane gases, which stretch the intestines.

Stating that “What suits the western gut may not apply to Asian intestines at all”, Dr Gwee went on to show evidence how the large intestine of Asians moved 2 times more quickly than French or Italian ones, and how Asians with Irritable Bowel Syndrome did not quite fit the western description of the disease according to the “Rome Criteria”, by being more distressed with incomplete evacuation of their bowels than with pain.

Indeed researchers from Asian countries have formed a separate group to study and identify unique features of functional bowel disorders that occur here. Led by Dr Uday C Ghoshal of SGPGI, the Indian workers recently published their observation of 3000 patients from across the country. Males in India seem to suffer, or at least complain, more than females who predominate in other parts of the world, and describe a mixed set of symptoms more commony than the “constipating” and pain predominant forms seen in western counterparts.

The role of diet could be important but not exclusively related to the bowel disorder. Dr Mahmud Hasan, an eminent researcher from Bangladesh, highlighted the overlap with dyspeptic symptoms in patients with IBS in their predominantly rice-eating population. He also drew attention to the possible role of spices, especially chillies, in both aggravating stomach symptoms, as well as increasing rectal sensitivity that give the familiar feeling of incomplete evacuation.

Treating Irritable Bowel Syndrome could be as complex as understanding its myriad causes and patterns. In a sudy described by Dr Gwee, good dieatary advice provided relief in only one-third of patients, most distressed patients requiring medications in addition. A combination of laxatives and antspasmodics provided relief in half. The best results of upto 80% was achieved when all the components of the “syndrome” were tackled, often with the addition of acid-suppressors and stress alleviators to the cocktail.

Functional bowel disorders affect around 10% of the population and constitute an ill-understood poorly managed group of disorders that make many suffer for years. Improved understanding and mangement strategies are finally helping to bring back the smile on the faces of these long sufferers.

As published in HT City( Hindustan Times) dated 7 August, 2011.

Ensure prevention from Hepatitis

If you thought that germs alone cause infections then think again!  Individual lack of awareness and reluctance to act promptly are often responsible for spreading of diseases!

As has been the case with poliomyelitis, a crippling disease ,caused by a virus. Government’s efforts of making its vaccine available in health centres, alone did not work. What had to be done was to reach out and convince each and every person for administering oral drops to their kids. And who could convince them better than Big B? Television served as the best medium to spread awareness.

Hepatitis B has a similar case. The virus can cause havoc in some of those that it infects. Prompt  action can, however, control a lot of potential damage. What is lacking is not the availability of effective and affordable vaccine but adequate awareness  among masses.

The World Hepatitis Day celebrated on July 28 was an occasion to do just that.

Picture 1

A big gas balloon, to spread awareness about Hepatitis,  floated in the city and  encouraged  all to seek more information about the deadly disease by SMS or through a phone call.

Those who missed watching the balloon, caught up with it through morning newspapers, which reminded them about Hepatitis

For those who still did not care, radio stations like FM Rainbow and Radio Mirchi poured reminders into their ears through catchy jingles and advertisements several times.

Picture 2

Shoppers who visited malls in the morning too were greeted by students wearing  anti- Hepatitis campaign tee-shirts.

Picture 3

Around  2100  people got  themselves tested this week for free in a specially held health camp in Lucknow, and more than 1000 took their first step towards protection with a shot of Hepatitis B vaccine.

Though small, a beginning has been made. I hope readers of this column would not let  this day pass without ensuring protection from Hepatitis B for  all.

As published in HT City( Hindustan Times) dated 31 July, 2011.