Recovering from Diwali

The eerie silence that follows Diwali can usher in gloom as the weighing -machine needle tauntingly veers to the right at this time of every year. Remorse at our recent gorging is the norm at such times, and getting back to shape with all the barfis and laddoos still filling the refrigerator, the challenge.

Getting back to exercise in this phase poses major hurdles. Our playmates have yet to return to the turf from their Diwali bashes. The bright five-thirty summer mornings have been swallowed by the night. And with the nip in the air, it is prime time to curl up and glimpse a few more frames of pleasant dreams as we wait for our morning cup of hot tea to drag ourselves out of bed.

Where and how then do we begin to arouse ourselves, start moving and regain the lost waist lines and belt holes?

Step 1: Shrug off the laziness.

My German friend Winfried, tells me that there is no equivalent to “wake up” in their language; they only have “stand up”!. I found this German habit of literally standing up beside the bed on waking up from sleep, quite challenging during my initial days at his home. At the sound of the alarm the whole family, children included, would toss their blankets and stand up as though ordered by an army commander. Although he was a compassioante friend with tremendous softness for his Indian visitor, he was intrigued to see me laze in bed a few extra minutes, and often asked me if I was running fever.

Step 2: Get going

Revert back to your daily quota of exercise. Those who exercise vigorously, pile up kilos rapidly as soon as they stop. Gym goers, players and dancers are particularly vulnerable. Each day without exercise counts. Therefore put on your jeans and sneakers and get going today; don’t wait for tomorrow.

Step 3: Give away the extra food in your house

The calories that we burn by exercise are relatively small compared with what our desi mithais and snacks contain: a glass of soft drink (100 kcal), a sweet (100-300 kcal), a handfull of dry fruits (300 kcal), a samosa or kachori (150 -300 kcal).

Burning the extra fat equivalent to 3000 to 5000 kcals gathered during Diwali is therefore not easy. To lose 300 kcals, we have to jog 30 minutes, or cycle for 70 minutes or lift weights for an hour. And do that for 6 long months.

Diet therefore holds the key to losing weight.  Subsist on clear soups, salads, 8-10 glasses of water a day and a morsel or two of sukhi chapatis. Stop eating when you are half full and try going hungry.

And give off all the sweets, snacks and pastries from your home to those who need them.  It will do a lots of good  to both!

As published in HT City(Hindustan Times) dated 30 October, 2011.

Breast lumps and caffeine

Caffeine, contained in coffee, tea, cola drinks and chocolates, has been in the eye of a storm swirling around breast lumps for quite some time. Says Dr Amit Aggarwal, consultant in the Department of Endocrine Surgery at the Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, “If young girls can give up coffee, tea and chocolates, their breast lumps often disappear miraculously”.

The issue had erupted few years ago when a lime-soda drink (7-Up) manufacturer had started advertising its drink as safe for women because it does not contain caffeine. Understandably, it upset the manufacturers of Coca-Cola and Pepsi-Cola, which do contain caffeine. They contend that 7-Up's advertising campaign was based on unsubstantiated health concerns.

Avoiding caffeine a xeno-estrogen, can be practically difficult. "Xeno" means foreign. Estrogen is the female hormone that causes breast development and dominates the first part of the menstrual cycle. Scientists now believe that xenoestrogens can cause fibrocystic breast disease and breast cancer. A strict avoidance of tea, coffee, chocolates and cola drinks do wonder to some breasts.

Breast lumps, localized swellings that feel different from the surrounding breast tissue, are indeed common, and occur in around 50% of women between ages 20 and 50. Contrary to the fearful thought that grips the mind on hearing of breast lumps, 90% of them are benign or non-cancerous.

Fibrocystic disease of the breasts, earlier called “fibroadenosis”, is overwhelmingly the commonest cause for breasts to feel lumpy and tender. They often get worse before periods.

Fibroadenoma is the other variety in which a localized firm to hard mobile swelling can be felt in the breast tissue. They often lie for years, and once their benign nature has been established, can either be left to lie for years without risk or removed by small surgery with minimal scar.

The conventional approach of aggressively removing most breast lumps by surgery, resulting to scarred breasts, is now somewhat outdated. Modern clinicians, by clinical examinations and backed by appropriate tests such as mamograms and cytology, can distinguish the cancerous from the non-cancerous quite accurately, and prefer to suggest less mutilating therapies for the benign lumps.

One of the simple strategies that Dr Aggarwal strongly advocates is attention to diet. Fatty food and caffeine are two major culprits. Switching to a high fibre diet that is low in animal fats, and avoiding caffeine often help many women.

Another recent strategy, that some belive works is a daily supplement of Vitamin E, that can be used in addition to the restrictions. “Drugs such as Danazol, with their side-effects, should be used only when these simple measures have failed”, says Dr Aggarwal.

As published in HT City(Hindustan Times) dated 23 October, 2011.

CRUELTY METER!

The young remorseless killer Andres Behring Breivik, who cruelly snuffed out 92 innocent young lives in Oslo recently in a cruel saga that shocked the world, had shown similar traits towards animals in his younger days. He is said to have loved hunting, and enjoyed killing innocent animals. Little surprise then that he shot 25 teenagers dead when they tried to swim away, like shooting fleeing birds.

The increasing violence in schools and society in recent years has, in most cases, began with cruelty to animals.  High-school killers in the USA such as Kip Kinkel and Luke Woodham of USA, tortured animals before starting their shooting sprees as did Eric Harris and Dylan Klebold, who shot and killed 12 classmates, admitted to mutilating animals.
 Dr. Harold S. Koplewicz, director of the Child Study Center at New York University. says about potential criminals, “You have a child who has symptoms of aggression toward his peers, an interest in fire, cruelty to animals, social isolation; many warning signs that the parents or school have ignored.” 

History is replete with serial killers whose violent tendencies were first directed at animals. Albert DeSalvo (the “Boston Strangler”), who killed 13 women, trapped dogs and cats and shot arrows at them. Dennis Rader (the BTK killer), who terrorized people in Kansas, had hanged a dog and a cat in his teens. A study in Australia revealed that “100 percent of sexual homicide offenders examined had a history of animal cruelty.”

It seems clear that acts of cruelty to animals are not mere indications of a minor personality flaw in the abuser; they are symptomatic of a deep mental disturbance. Research in psychology and criminology shows that people who commit acts of cruelty to animals don’t stop there—many of them move on to their fellow humans. Abuse of innocent helpless animals should ring alarm bells. These people are likely to abuse helpless people in family and society too.

Schools, parents, communities and courts in developed countries are beginning to realize that shrugging off cruelty to animals as a “minor” crime is like ignoring a ticking time bomb. Communities must recognize that abuse to any living being is unacceptable and endangers everyone.

It is worth teaching children to care for and respect animals. After an extensive study of the links between animal abuse and human abuse, two experts concluded, “The evolution of a more gentle and benign relationship in human society might be enhanced by our promotion of a more positive and nurturing ethic between children and animals.”

Parents would do well in not ignoring even minor acts of cruelty to animals by children. If children can be taught to love animals, starting with the most helpless, sad, deserted ones on the streets, they will learn to love fellow humans, their sibs, parents, friends and future spouses as well. But for that, parents and teachers need to lead by example!

As published in HT City(Hindustan Times) dated 16 October, 2011.

Bright strokes to pink health!

A recently held poster-making competition organized by HOPE Initiative (www.hope.org.in) on 22^nd September in which 170 artistically-inclined school students representing 36 schools took part, once again drove home the point that perceptions and emotions, rather than dry bits of medical information, often shape our attitudes towards health and its hazards.

Pix 1: Students pouring imagination and colours on to their posters

The Governor of UP Shri BL Joshi, who graced the ceremony in Lalit Kala academy as chief guest, expressed appreciation and intrigue at the imaginative and creative ways in which students from class 6 to 12 had depicted topics ranging from “Life Style Diseases” to “Road Traffic Accidents”.

Pix 2 : Shri BL Joshi surveying the posters

“Health” can be as boring a topic, if students are lectured on the virtue of eating apples, to an as amazingly exciting one if they are encouraged to research and present issues as they see through their own eyes. Sample this poster on “Life Style Diseases” by Arindam Aggarwal of Jaipuria School, 

which was unanimously judged the best.

Pix 3: Poster on Life Style Diseases

One of the reasons behind HOPE Initiative’s success to transform the topic of “health” that sounds remote to students 

to one that engages them, has been its innovative methods

 through which it has touched the lives of around 500,000 students and their families through 2500 programmes in 

1200 schools of UP over 7 years.

Pix 4. : Award winning poster on hepatitis

What added icing to the cake were the glittering ceremony and the rare honour of receiving the prize from as important a person as the Governor, and getting their pictures with him clicked and saved for posterity.  “Health” got the boost among students it 

deserves. Cheers!

Pix 5 and 6: Awardees with Shri BL Joshi

As published in HT City(Hindustan Times) dated 9 October, 2011. 

The Lesson of My Life

As a medical specialist, armed with voluminous knowledge of diseases, skills and several years of experience, I had started exuding a good degree of confidence, somewhat more than what my wife felt was desirable.

It was around then that a frail, 83 year old lady came to see me for abdominal pain, jaundice and fever. She was as apprehensive of me as a doctor as I was of her old age. The duct through which bile flowed from her liver to the intestines was blocked and converted into a bag of pus with stones. It was not without trepidation that I offered to pass a rather thick endoscope down her throat to the intestines, pass an electric wire into the lower portion of her bile duct and cut out and clear the passage through ERCP. I did not mince words in explaining to her sons the considerable danger that the procedure carried in her vulnerable condition. The patient on her part agreed to take the chance.

With two of my juniors keeping strict vigil on her pulse and respiration, two nurses assisting me with the instruments, and innumerable beads of perspiration breaking out shamefully on my forehead, I gently manoeuvered the endoscope  past her vocal cords into her foodpipe. Then it seemed to descend effortlessly down to her intestines.

I inserted the electric knife into the lower end of the clogged bile duct, pressed on the footswitch slitting the narrow opening and letting out a gush of pus and dirty bile into the gut. The procedure couldn’t have been more perfect. Several of her children, grandchildren, well-wishers and friends looked admiringly at me as I explained with pride the complicated lifesaving feat that I had accomplished.

Encouraged by her dramatic improvement at my hands, her daughter-in-law came to consult me for gallstones, one of which had slipped into her bile duct. She was around 40, young, pretty and appeared a picture of perfect health and happiness. I proposed the same ERCP to her.

This day somehow turned to be another day.The bile duct opening was sticky and blocked and wouldn’t let the electric wire-knife in. I changed the angle and tried again and again, but did not succeed. I went on trying all the tricks I had learned during my training fellowships in Japan and Germany, but failure haunted me. My clothes were soaked in sweat when I finally gave up.

I lay in bed soaked in shame and hurt, trying to rerun the events of the day in my mind, wondering where I had gone wrong. After wandering through the catacomb of logic and science without a meaningful answer, I began to realize there was perhaps something quite beyond my brains, my hands and my skills. As the thick crusts of arrogance began peeling off my heart, I could hear the words of Ambroise Pare, a 16^th century French surgeon, echo in my ears:” I cleaned his wounds but God healed them”!

Valuable lessons often come from unsuspecting sources and in innovative ways. 

As published in HT City( Hindustan Times) dated 2 October, 2011.