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Posts Tagged ‘Lifestyle Diseases’

ashokbhatia

Lifestyle diseases like diabetes and hypertension have a tendency to quietly enter the house of our physical bodies, much like unbidden and unwelcome guests. In most of the cases, repeated attempts to entice these to depart and scour around for some greener pastures are unsuccessful. After the first stage of shock and denial has passed, a state of active acceptance comes about. The basic principle of a peaceful coexistence eventually gets followed.

Diabetes is labelled as a silent killer. This unwelcome guest has a tendency to enfeeble almost all the organs of the body. Its special affection gets directed towards ones which are already in a state of disrepair. These could be our heart, eyes, kidneys, feet or any other organ or limb which catches its fancy. Nerve endings get compromised. Initially, some tingling sensations may be there, more bothersome at night. Over time, sensations may be lost completely, leading…

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Lifestyle diseases like diabetes and hypertension have a tendency to quietly enter the house of our physical bodies, much like unbidden and unwelcome guests. In most of the cases, repeated attempts to entice these to depart and scour around for some greener pastures are unsuccessful. After the first stage of shock and denial has passed, a state of active acceptance comes about. The basic principle of a peaceful coexistence eventually gets followed.

Diabetes is labelled as a silent killer. This unwelcome guest has a tendency to enfeeble almost all the organs of the body. Its special affection gets directed towards ones which are already in a state of disrepair. These could be our heart, eyes, kidneys, feet or any other organ or limb which catches its fancy. Nerve endings get compromised. Initially, some tingling sensations may be there, more bothersome at night. Over time, sensations may be lost completely, leading to problems which do not even get felt.

Excessive thirst and frequent urination are the well-known symptoms of diabetes. These could easily get ignored and we could chug along in our lives, blissfully ignorant of the arrival of this unbidden guest amidst us. With urine, the body also ends up ejecting some minerals. The disease leaves one feeling tired and exhausted.

The alpha and beta of diabetes

At the core of this affliction is an organ known as the pancreas. Due to genetic reasons or owing to prolonged abuse, there are times when it refuses to behave like an alpha male. It ceases to run on all its twelve cylinders. It does not produce enough insulin, the hormone which controls blood sugar levels in the body.

The beta cells in our pancreas not only produce insulin but also govern the sugar level fluctuations in the body. So, the higher the level of blood sugar, the higher is the fluctuation of sugar levels in general. The fact that South Asian genes happen to be more susceptible to attracting this disease does not really comfort someone who is actually suffering from diabetes.

There are those in whose case the cells that produce insulin are selectively lost. They would qualify to be suffering from Type 1 diabetes.

The body surely needs sugar to keep active and kicking. But when the sugar intake is more than what it can handle, insulin production lags behind its demand. The pancreas is unable to keep pace. Those whose pancreas has started losing its efficacy over a period of time get categorized as having Type 2 diabetes. Often, obesity rules. The battle of the bulge gets lost. Pear pressure kicks in.

Then there is a portion of humanity which shows signs of an imminent onset of diabetes. These could be called pre-diabetics. Surely, there is some hope for them, provided they adopt an active lifestyle, change their diet pattern, and do not allow diabetes to walk in.

The delicately nurtured amongst our species, when they happen to be in the family way, face the risk of gestational diabetes.  Though it is a temporary condition, they end up having a higher predisposition towards Type 2 diabetes.

Sharing some key observations

Yours truly is neither a physician nor a person even remotely connected with the field of medicine. Nevertheless, here is a summary of what one has learnt so far. Some of you might find these of use. These observations pertain to Type 2 diabetes.

Blood sugar levels are a function of the following major factors:

  • Stress: The higher the stress levels, the higher the blood sugar levels. A prolonged challenging situation – whether on the home front or on the office front – could reduce the immunity levels of the body and increase the sugar levels.

Laughing things off helps, so does the company of those who exude positivity. Building up inner resilience reduces the impact of external circumstances, and thereby helps in controlling sugar levels better.

  • Physical activity is a basic factor. Be a couch potato or a chair tiger and repent at leisure. Regular brisk walks and light exercises help. But these produce results only after about six weeks, by which time the body forms a habit and starts demanding its daily dose of whatever physical regime you decide to follow.

Pottering about in the garden or in the kitchen and doing household chores provides some protection. Climbing up stairs and not using an elevator helps. Living life with lesser dependence on your favourite Ferrari helps.

But nothing to beat the efficacy of either cycling or a brisk walk, which is closer to the way a soldier would typically walk. Sweating it out is a key factor. It also helps with heart-related issues.

Much like a tube light needs an initial surge of additional power to get going, the body also needs an initial impetus of will power to walk the first 500 meters. Thereafter, once it has warmed up, a brisk walk often sounds more like a cake walk.

  • Medication cannot be taken lightly. It needs to be taken regularly, on time. This implies that meals required to keep the body and soul together also need to be taken on time, day after day.

Oral medication is convenient. At times, if it is unable to bring blood sugar levels within control (fasting values in the range of 70-100 and other values being in the range of 120-200), the physician may prescribe insulin injections.

Insulin has a singular advantage of the necessary hormone reaching the blood stream directly. But the flip side of using insulin, or any other anti-diabetic agent, is the risk of blood sugar dropping down to such dangerous levels as 60 or below. Symptoms could be tiredness, giddiness, excess sweating, palpitation and even coma and other          complications. This could even prove to be fatal.

To avoid such complications, a bar of chocolate, some dry fruits and biscuits should always be kept handy. Sugar cubes could also help. A glucometer needs to be used to immediately check the blood sugar levels and the incident reported to one’s doctor.

  • Diet is a crucial factor in managing diabetes. Our scriptures often extol the virtues of leading the life of an ascetic or a monk. Diabetes propels us towards such lofty goals in life. Controlling our taste buds is a serious challenge and needs nerves of chilled steel. When a piping hot junk food item like a ‘samosa’ comes up in front of us, or when a ‘rasgulla’ gets lovingly offered by an otherwise well-meaning friend, the deep reserves of our tenacity have to be marshalled to refuse these and instead pick on a green salad.

Even fruits like mangoes and bananas are harmless, if taken in moderation and if in the absence of any other item on our plate.

Some tests and parameters

  • Regular checks on blood sugar levels (fasting as well as postprandial, PP) are highly recommended.

For fasting level to be correctly ascertained, during the previous night, except for plain water, nothing else should be consumed after 10 PM. Medicines to be taken after the test. Normal breakfast can be had after about 30 minutes.

For PP, a reading would need to be taken two hours after breakfast, with nothing else being consumed in the meanwhile. Any deviation from this procedure can be brought to the notice of one’s physician.

  • Once in six months, our physician may recommend a test known as HbA1C. This one tells us the weighted average of our sugar levels over a period of the past three months, thereby indicating the extent of control we have exercised over ourselves during that period. A value below 7 would normally indicate a fair amount of control, though the exact value is best decided between the doctor and the patient.
  • Frequent eye and feet check-ups are necessary. Once in a year, functioning of the kidney needs to be reviewed by means of appropriate tests.

When prolonged tension leads to hypertension

Yet another lifestyle disease which creeps up on one is that of high blood pressure. If left unattended, this could result in the hardening of arteries, cardiac problems and an increase in one’s intraocular pressure in the eyes. Keeping this on a strict watch is in some ways even more crucial than regular monitoring of blood sugar levels.

Of doctors and miracle cures

The role of a doctor in managing diabetes is more akin to that of a guide. The hapless physician has no clue as to what our daily meals comprise and the amount of liquors and desserts we gobble up at social events.

Often, we may come across miracle cures made by those who are proficient in alternative streams of medicine, claiming to get us rid of diabetes in a short period of time. If followed, these could achieve good results in the short run, but could do more harm to the body in the long run. The reason is simple – these are not sustainable. In a controlled environment, these cures could really work. But when we are back in the civilization, living our routine lives and facing all the harsh slings and arrows of Fate, the short-term benefits could simply evaporate. However, there is a general belief that some medicines from alternative streams do work as supplements, somewhat nullifying the side effects of allopathic medicines.

A helping hand from the government  

One has no statistical evidence, but there is no doubt that those suffering from this lifestyle disease do end up suppressing the economic growth of the country they inhabit.

Revenue-hungry governments world over could think of imposing a hefty ‘sin tax’ on all things sweet. Tax breaks can be offered to those who suffer from a lifestyle disease. The delivery of public health services can be strengthened.

The civic authorities would do well to ensure that there are adequate provisions for bicycle tracks and for taking brisk walks in open spaces for its denizens. Public transporters could pitch in by ensuring availability of diabetic diets to those who might be in need of the same.

The trick of managing a lifestyle disease

The real control of diabetes and other lifestyle diseases rests in our own hands. Guided by a competent physician, management of these is no rocket science.

Basically, the trick lies in holding our chin up, looking ahead to a joyful life with clear eyes, and marching on with our lives, wearing this affliction as a badge of honour on our sleeves, aspiring to evolve spiritually, with nary a wrinkle on our forehead.

Bertie Wooster and Jeeves would heartily approve of a sunny disposition of this nature. So would Ashe Marson of the ‘Something Fresh’ fame.

(Inputs from Dr B S Suryanarayana, Additional Professor, Department of Medicine, JIPMER, Pondicherry, are gratefully acknowledged)

(Illustrations courtesy www)

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https://ashokbhatia.wordpress.com/2013/08/04/getting-india-in-the-pink-of-health

https://ashokbhatia.wordpress.com/2014/10/06/handling-the-diabetes-tsunami-in-india

https://ashokbhatia.wordpress.com/2015/07/01/how-diabetes-helps-us-to-improve-our-sq)

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ashokbhatia

The conscientious ones amongst the mandarins in the Indian Health Ministry cannot really be blamed for having sleepless nights. The epidemic of such lifestyle diseases as obesity, diabetes, hypertension and cardiovascular abnormalities is leaving them a wee bit clueless. The need of the hour is to come up with a scheme which nudges Indians of all sizes and shapes to start living slimmer and healthier lives.

Take obesity, for instance. As many as 60 million Indians – roughly 5% of the population – are considered obese. With more than 50 millionObesity image suffering from high blood sugar, India is a nation headed for a health tsunami the devastation caused by which would be anything but sweet. This is a grave threat to our vision of the country reaping a hefty demographic dividend in the years to come.

How do we motivate the Indian couch potatoes to switch off their TV sets…

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On the occasion of World Diabetes Day…….

ashokbhatia

My dear, never did I dream of being with you,

With silent feet you waltzed into my life, it is true.

 

You came in and took control of all aspects of my life,

All kinds of sweets and savouries are now denied by my loving wife. 

 

When others feast on dishes and foods exotic,

You make me learn the art of detachment and turn me into an ascetic.

 

To remain aloof from all kinds of cuisines and tastes,

You exhort me to walk, exercise and not let my life go waste.

 

I abide by all your wishes and try my best to keep you in good cheer,

I live like a recluse, satisfying all your demands, dear.  

 

When it comes to taking good care of me, my wife is near perfect,

But all my vital organs you alone appear determined to effect.

 

O dear…

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When a loved one suddenly falls sick, our first reaction is that of disbelief. Then comes denial.Caring Michelangelo's_Pieta Superior powers get questioned as to why they thought it fit to bestow the loved one with such a challenge. Gradually, acceptance dawns and one moulds the activities of one’s life around the new core of reality. The health challenge could be either an accident or a serious ailment or even a lifestyle disease which behaves like an unbidden guest who refuses to go away.

How does one manage a change of this nature? Well, here are seven habits which can be cultivated to transform a wide-eyed and bewildered soul into an effective Caregiver.

Communicating as per the Psychology of the Patient

There are patients who prefer to show off their illnesses to any and all who express concern. They would prefer to wear their ailments on their sleeves, much like a Chopard watch. Then there are those who would consider an illness a strictly private affair, not to be discussed even within their close circle of friends. Based on the category under which one’s loved one falls, a Caregiver would tailor his/her communication to those around accordingly.

When it comes to communicating with a patient, there could be occasions on which the Caregiver can choose to be a hypocrite. Even if the Caregiver harbors a seething anger and a burning anxiety within his/her bosom, it helps to maintain the sang froid, so to say. A calm exterior and a cheerful disposition on the Caregiver’s part radiates a youthful energy all around, thereby lessening the level of anxiety and the fear of the unknown felt by the loved one.

Expecting the Unexpected

Lifestyle diseases are silent killers. These tend to accelerate the ageing process. Since all organs of the body are interconnected, complications involving other vital organs of the body could start popping up at unexpected times. It surely helps to have a prognosis and a crisis handling plan in place so as to minimize the subsequent setbacks, if any.

Cultivating a Circle of Doctors

The leisurely days of having a single family doctor are no longer with us. Considering the prognosis of the disease, it helps to have a circle of three kinds of medical experts. A specialist who addresses the core sickness, a generalist who can advise on side effects of drugs and can take care of peripheral issues as and when these come up and a group of friendly doctors which can be counted upon to provide a second opinion and whose help can be invaluable in case of an emergency.     

Being Prepared for a Long Haul

Lifestyle diseases creep in on one rather quietly. Once these settle down in the body, it is notPatient Medicines easy to wish these away. Yes, a sustained effort supported by exercise, meditation, medication and a positive mindset do help to keep these under check. One therefore needs to be prepared for a long haul, needing a strong will power and perseverance, especially on the Caregiver’s part.

Mind over Matter

It is critical to ensure that the patient remains relaxed and happy. Thus, it is important to create a stress-free environment with as much fun and frolic thrown in as possible. Knowing what makes the person happy and arranging the same is of crucial importance. A Caregiver needs to be prepared to make sacrifices to give up his/her own beliefs and individual fancies to ensure that the patient remains in a positive frame of mind.

Advising Wisely

The worst thing a Caregiver can do is to compare the condition of the patient with that of another afflicted with the same disease. Each individual is uniquely configured. Even though the broad principle of a treatment may be the same, there could be many variations based on the individual condition and temperament of the patient.

Advice should be given only when it is sought. Unsolicited inputs end up confusing and demoralizing the patient. Heresy dressed up as wise counsel often comes in from those who come calling on the patient. A Caregiver’s role is that of a filter which ensures that the patient receives a feedback which is balanced and objective.

Taking Care of Oneself

A Caregiver cannot afford the luxury of being sick himself/herself! The primary responsibility Caring Michelangelo_pietà_rondaniniis to take care of oneself, so the support provided to the patient does not get diluted.

Such habits, if inculcated by the Caregiver consciously, can help the patient to recover faster and better.

Overall, an important issue is that of the will and faith of the patient. If the patient believes that all will be well, good health is quite likely to follow. Faith in the doctor, as also in the medicine being taken, can work wonders. The Caregiver’s primary task is to create and sustain this belief in a realistic manner.

Those of you who face a similar challenge in life may like to comment and add a few more habits which they find useful. 

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We appear to be headed for two new challenges to our mental equipoise in this century – Nomophobia and Noconnphobia! The fear of being out of mobile contact, that is, NoMobile-Phobia, is already well-recognized. The significance of the other, NoConnectivity-Phobia, is perhaps yet to dawn on most of us!

Our addiction to mobile phones and internet knows no bounds. Six years back, I was working with a company in a very senior position. A night before I was to be wheeled into an operation theatre for a cardiac surgery, I was furiously making calls to my team members to ensure that things were handled right when I was away from work for some time. My distressed daughter ended up confiscating the mobile phone, leading me to a feeling of utter loneliness and helplessness. It was as if my world had collapsed!

While recovering over the next four weeks, the ring tone of the mobile phone kept ringing in my ears, even though the equipment was nowhere around. My family ensured I could not lay my hands on it; otherwise, they felt, and rightly so, that I shall again get hooked on to it!

Surrounded by Gizmos!

Mobile phones are now everywhere. We go to a restaurant, and find that the friends who have met only to have a decent time together are instead glued to their individual mobile phones, chatting away merrily with those who are not physically present. On the roads, we find young and old alike walking absent-mindedly, talking on their mobile phone, quite oblivious to the traffic whizzing past and around them. Two-wheeler riders continue driving with an eye on the road while talking to someone far away, with a mobile phone wedged between their hunched up shoulder and an ear. With the arrival of blue tooth, the hunched shoulder has disappeared, but not the ingrained habit of using this all-pervasive gadget while driving.

Travel in a train and chances are that all the passengers are calling up their near and dear ones at the same time, prompting us to avoid the cacophony by taking a stroll down the crowded aisle. Visit a family and just as we start relishing a cup of tea with them, a shrill ring tone distracts one of the host’s party and we start wondering when the conversation in the drawing-room shall resume. Attend a management talk by an eminent expert, only to be interrupted by someone’s mobile ringing loud and clear, leaving the hapless expert clueless and the audience twiddling its thumbs. Even group meditation sessions are not free from this scourge.

When we call up a person on his mobile, we seldom bother if it is an appropriate time for him to have a conversation. If he does not pick up the phone in four or five rings, we conclude that he is being rude and arrogant; the poor guy might just be having a quiet candle-light Valentine Day dinner with his fiancée!

Internet is Fast Catching Up

Same is the case with internet accessibility. It appears to have assumed the same significance in our lives as oxygen which is vital to our survival. Withdraw it and the person withers away like a plant which has not been watered for quite some time. Ask any bleary-eyed child why he is looking tired and sleepy and the reason could well be that the only book he was working on the previous night was Facebook!  The realization that there is a real world out there – which is not the same as the virtual world – is difficult to come by.

According to a 2008 study in the UK, 53% of cell users there suffer from Nomophobia. It is not too different when compared to the stress we feel when we visit a dentist, start a new job or get jitters on our wedding day!

The day is not far off when some of us would be so lost in our technical gizmos that we may end up having to ‘Google’ ourselves to find who and where we are! With the convergence of voice and data services, we may soon end up getting mini-sim-cards planted in our skulls, much like the character of Neo played by Keanu Reeves in the ‘Matrix’ series of movies a decade back.

Just like the advent of the internal combustion engine changed our lifestyles forever, easy availability of connectivity is contributing towards making our civilization even more sedentary. The onslaught of lifestyle related diseases like diabetes, hypertension and cardiovascular complications is getting further speeded up with our addiction to internet. Our transition time – from being a couch potato at home to becoming a patient in a psychiatrist’s couch – is possibly getting shorter.

Enjoying Freedom with Responsibility

It is not my case that newer technologies are bad. Thanks to social networking, distances have shrunk – physically as well as mentally. A virtual democracy of information has led to grouping of like-minded individuals. Regimes world over are waking up to the potential as well as the power of internet, as we have seen in the case of the ‘Arab Spring’ and also in the recent case of a brutal gang rape case in Delhi.

We have enviable options today to remain connected with the world, but there is an overload of information. We need a higher level of maturity and wisdom to be able to moderate its usage in our day-to-day lives. We need a higher degree of inner strength to be able to sift between what is relevant and truly beneficial for us, and whom we associate and network with. It is up to us to enjoy this new-found freedom with responsibility.

We have to take a conscious call whether we wish to use the technology to our advantage, or to become slaves to it, 24 x 7! Yes, it is not easy to switch off our smart phones, I-pads, tablets and laptops. But there is no other way but to do so at select times during the day. Let us give our gadgets some well deserved rest.  Overcoming Nomophobia and Noconnphobia is not as hard as it sounds!

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