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| HEALTH TRIBUNE |
Knowledge is bliss in getting cured Weather
conditions do trigger migraine
Kidney stone: useful tips Ayurveda & you |
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Knowledge is bliss in getting cured
DURING one of those hot and humid patches of monsoon when we all expect rain to fall but the gods decide against it and let us literally stew in our own juices, Udit Vinayak was born. What followed in the next week or so clearly established that ignorance is not bliss, knowledge is. The doctor told us that he had a little problem. But bad news, even when broken gradually, remains bad news and it really does not help when sundry elders insist on providing well-thought-out analysis of what has happened and why. I actually heaved a sigh of relief when I saw Vinayak a little later. He merely had a cleft lip and palate. Immediately both Meeta and I knew that we would be able to handle the situation well. Still we would have been better prepared had the various doctors who had been checking out the unborn child every day during the past week had given us some advance information. It took us a while to figure out that the visits of relatives at this juncture only stressed us all, for, there was little by way of understanding that they had to offer and much by way of unstated recriminations. Some of the doctors who arrived to provide advice were no better. The first paediatrician, a young fellow recently out of college, went on and on about how difficult it was to bring up a cleft palate child. A still more senior paediatrician, retired from a teaching post, hove into sight a couple of hours. She pontificated a little and laid down the stuff on difficulties more heavily. A few days later a plastic surgeon, identically retired, arrived and suggested a life-long course of treatment that he and his friends would offer. When we asked these worthies what they proposed to do and how, they had it conveyed to us that we were asking too many questions. That was the end of our efforts to seek help and advice from those around us. At this point two things came as absolute saviours. A distant relative settled in the US sent us a few kilos of pamphlets and books from the Cleft Palate Foundation. And we decided to visit the PGI despite the heavy rush and long wait in claustrophobic halls that it entailed. The books and pamphlets were reassuring on two counts. One, they provided information, in simple and non-technical language, about the meaning of a cleft lip and palate. Two, the various everyday strategies needed to take care of the child as also the nature and extent of medical intervention that was needed, both immediately and in the years to come. The same information was reiterated and reinforced by the doctors at the PGI. The doctors also laid down a specific time schedule that we needed to follow for Vinayak’s treatment. While we put the above advice to practice, we also took shelter in that popular baby-care adviser: Dr Spock. It came as a pleasant surprise that bringing up a child with cleft palate was no different from bringing up a child without a cleft palate. If there was a difference it was just this: greater care had to be taken in the former case so that there was no possibility of the child falling ill under any circumstances. Remaining healthy was important since this would ensure better growth and weight gain, and enable that the child was ready for his first repair procedure at the earliest opportunity. Moreover, there was considerable satisfaction in ensuring good health for the child. Off and on, we even boasted about such achievements. Such bragging, unacceptable in some societies and cultures, can do wonders for one’s self-confidence and well-being. The complete repair procedure was carried out at the age of nine months in the sweltering month of May. He had to be admitted to the hospital for a week. The high fevers that followed the operation were taken care of by cooling him in the blast of an AC. For a few days two-foot long Vinayak had his arms swaddled in plaster so that he would not disturb the stitches on his face. All naked, except for a diaper and the plaster, he attracted a lot of comment from people around. A little later Vinayak landed up on the orthodontic chair. Every six months or so when he would visit Chandigarh we took him for this orthodontic visit. In the interim the Cleft Palate Clinic at the PGI had sent Vinayak for speech therapy. On his first visit he merely gurgled at the therapist — ga ga ga. "Can’t you speak", I asked. "Ga ga ga", he replied. After 10 minutes of such gagaing the therapist referred him to the psychotherapist to get his IQ checked. He scored a healthy zero over there too for being utterly uncooperative. So, we took him home. "Why didn’t you say anything", Meeta asked. "I didn’t feel like it", he said. After a week his relationship with the therapist settled down and he became more cooperative. For two years special care had to be taken of Vinayak’s throat. "No infection allowed", the ENT man told us. That resulted in our spending many hours inside a mosquito-net that had been converted into a steam-bath. Vinayak’s throat remained infection-free and we, who sat with him, got a free sauna. Now Vinayak’s problems, such as they were, had become a family affair. Then one day we were told that he had to be operated upon for an ear-ache which refused to go. That was an operation requiring admission to the hospital. But by now Vinayak had got adjusted enough to the hospital atmosphere not to worry about it and also tell us not to be unduly worried. It also helped that we had tremendous faith in the competence of the doctors performing the task. All this is merely to say that as he
grew older he continued to participate whole-heartedly in all the
activities that boys his age do. School was no different either. He
did well on some occasions, badly on others, but overall being among
the top 20 per cent of the class, with maximum marks in some subjects.
As of now, thanks to all the information and care provided by the
doctors and the literature from the Cleft Palate Foundation, the cleft
business has become part of history and life goes on its usual normal
course.
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Weather conditions do trigger migraine Washington: Though for long, doctors have kept brushing aside patients who thought the weather could trigger their migraine headaches, a new research has supported the view. According to a report in the Health Scout, the research has found that weather conditions can unleash the withering headaches in as many as half of all sufferers and cold and dry conditions are the most common culprits. The study was conducted by Dr. Patricia Birgeneau Prince, as part of a project at The New England Center for Headache in Connecticut. Some people prone to migraines tend to blame high temperatures and humidity for their headaches. And that can be the case. However, the study found that a combination of low humidity and cold weather is more likely to blame. Other weather triggers for some patients include shifting weather patterns, and changes in barometric pressure or extreme barometric pressure. About half the patients in Prince’s study were truly affected by the weather. Before the study started, 85 per cent were convinced weather was their nemesis.
Experts recommend that people who
believe they suffer weather-induced migraines keep a calendar for
several months. They should note the pattern of their headaches and
the weather conditions when each headache hits. — ANI
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Kidney stone: useful tips Question: What are the important causes? Answer: Vitamin A deficiency causing damage to the lining — urinary epithelium — decreased uninary citrate, kidney infection (with urea splitting organisms), obstruction to the free passage of urine, prolonged immobilisation as in paraplegia, inadequate water intake, hormonal like hyper parathyroidism, i.e. over-functioning of the parathyrod gland. Q: What are the various of kidney stones? A: Oxalate-mulberry stones (commonest), phosphate (usually calcium phosphate), uric acid and urate usually multiple-facted (not visible on X-rays when pure), cystine in patients with cystinuria, xanthine (rare) indigo — rarer. Q: What are the patients’ complaints? A: Pain, dull aching or sharp colicky (coming from behind forward) with nausea, vomiting, frequent desire to pass urine, sometimes mixed with blood (haematuria). In ureter stone: pain from the loin to the testicle; a bladder stone may cause sudden stoppage of urine. Q: What investigations should be undertaken? A: A detailed patient history and examination followed by plain X-ray KUB (kidney ureter bladder) area after proper preparation, urine, blood urea and serum creatime examination, ultra-sonography KUB, intravenous urography. Q: What happens if you do not treat such patients urgently? A: Besides the patient suffering repeated colics, stones give rise to haematuria, urinary infection, increase in size, gradually damaging the kidney, ultimately uremia — kidney failure. Q: What are the management techniques? A. For renal colics: IV drugs like Fortwin — phenergan — IV Baralgan. b. ESWL- lithotripsy for stones up to 2 cm. c. PCNL key hole surgery for larger stones. This operation requires only 1 cm. incision. The stone is either removed intact or broken into pieces and removed with endoscope. d. URS (Uretero Renoscopy) with the use of highly specialised endoscopes, stones in the ureters, specially in the lower third, are removed from the ureter without a wound or a scar. e. Open surgery in occasional cases when the above methods are not indicated. Q: What is ESWL (extra-carporeal shockwave lithotripsy) ? A: A special machine is used to break stones within the body without an incision. Powerful shock-waves are generated by the machine and focused on the stone. The powdered stone particles are passed in the urine. Q: Does a patient require admission to hospital for lithotripsy? A: No. It is an outpatient treatment. The patient walks in empty stomach, is subjected to lithotripsy under deep sedation — not general anaesthesia — stays at the clinic for three or four hours and walks back home the same day. Q: What are the complications of ESWL? A: None. Some patients have blood in urine for two or three days and local pain, which is relieved by drugs. They require one or two days’ rest at home. Q: What are the results of ESWL? A: The success rate for kidney stones is 85 per cent and ureteric stones is 65 per cent. Results are improving. Incidentally, the procedure is more economical and open surgery is avoided. The writer, a retired Major-General,
is a Chandigarh-based urologist. |
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Ayurveda & you In all age groups, prevention of disease is considered to be a better proposition than cure. It is more so in the elderly because people from other age groups may easily recover from a disease, where old people do so slowly or partially. Therefore, disease prevention in their case always carries immense importance. Ayurveda, while laying stress on the preventive aspect of health, suggests a number of methods to be adopted in the day-to-day life to keep the disease away. In the changed social scenario, many of these points need to be redefined. Though the primary aim of disease prevention is to maintain optimal health, an effort in this direction also serves to detect ailments at an early stage, thus preventing its progression. Furthermore, the preventive aspect of the disease in old persons involves not only self-care but family support also. In the present times self- care serves as the first step in the prevention of disease. Ayurveda emphasises that a person should himself follow the right conduct regarding maintaining his personal hygiene and following the seasonal regime and daily routine to maintain good health. Acharya Charaka, while describing the right diet, proper and timely sleep and sexual discipline as supportive pillars, of life tells that a wise person should be vigilant for maintaning his own body, always striving to keep itfree. Self-care in old age
also denotes small health tips like controlling weight, stopping
smoking and avoiding alcohol. Over-weight predisposes to
osteoarthritis, diabetes and hypertension and makes old persons
accident prone. Similarly, smoking increases the To an extent, regular health check-up of the elderly also serves as a preventive measure against many diseases. The evaluation should include a thorough history and physical examination. Monitoring of blood pressure and other vital body functions and laboratory tests to rule out diabetes, high cholesterol and impairement of the kidney function must be taken up periodically. An early indication of a disease and timely diagnosis are always helpful in managing it in a better way. Old people should take medicines as prescribed by their physician, and if and when any tonic or supplement therapy is needed they should follow it properly. A comprehensive health care of the elderly people should also ensure that their all psycho-social needs are met. The vanishing joint family system makes the financial security a necessary component of preventive health care of old persons. If adequate nutrition and other daily requirements are becoming expensive, the price of specialised medical treatment is just turning to be prohibitive. Old people should also guard themselve against any complication arising out of their pre-existing disease. A healthy social network, including supportive family, good friends and hazard-free environment, is also very necessary in old age. Ayurvedic texts
explicitly make family members duty-bound to take care of the elders
in the family. "Aptopseva" or devotion and concern towards
parents or other old persons in the house has been described a sacred
responsibility of children. Preventive health care of the elderly
cannot be complete unless they are nicely looked after, loved and
appreciated, and their position and security within the family is
assured. Those belonging to the younger generation should always
remember that they are tomorrow’s The writer is a
Ludhiana- based ayurvedic physician
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