anemia

Blood debt Dr Gita Mathai Statistics say that about half of the Indian population, across age groups, sexes and economic strata, is anaemic. Since anaemia - a condition when a person does not have enough healthy oxygen-carrying red blood cells circulating in the body - affects both the efficiency and endurance of a person, you have to get rid of it if you want to realise your full potential. The initial symptoms of are vague and non-specific - lack of energy, unexplained mental and physical fatigue, giddiness, headache, low body temperature and pallor. Pregnant woman and children may develop a perverted appetite (pica) with a desire to eat things such as clay, chalk, bricks or ice. Anaemic women can have stillbirths or small unhealthy babies, and even die during childbirth. Anaemic children are smaller than their peers and have impaired cognition and problem solving skills. They perform poorly in school. They also have frequent respiratory and intestinal infections. All the organs in the body require oxygen to function efficiently. As the anaemia worsens, the supply of oxygen lessens. Signals are sent to the heart, which has to pump harder to get sufficient oxygen to all organs. This can result in abnormal rhythms and even heart failure. The most common cause of anaemia is deficiency of iron. Iron is present in lean meat, poultry and seafood. Vegetarians can get iron from lentils, legumes, soya products and nuts. Plants contain relatively less iron and much of it exists in combination with organic compounds called phytates, which making absorption difficult. Anaemia can also result if there is sudden or chronic blood loss, like in heavy periods, piles or haemorrhoids, gastric or duodenal ulcers, or even worm infestation. In the case of chronic illnesses such as kidney or liver disease or heart failure, the body just may not produce enough red blood cells. This is called the "anaemia of chronic disease". Production may be affected by lack of vitamin B12 or folic acid. Sometimes the bone marrow shuts down and does not produce red blood cells, a condition called aplastic anaemia. This may occur due to radiation, exposure to toxins or as a reaction to certain medications. In some inherited conditions such as thalassaemia or sickle cell disease, the haemoglobin in the red blood cells is faulty. Anaemia is confirmed with blood tests to determine the haemoglobin levels. Normal values is usually 13.7 g/dl in males, 12 g/dl in females and 11g/dl in children. Sometimes, vitamin B12 or folate levels, a bone marrow aspiration or haemoglobin electrophoresis may be required. Gita Mathai is a paediatrician and author of Staying Healthy in Modern India . Mail your questions on health issues to yourhealthgm @yahoo.co.in

 

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The patient’s blood sugar refused to go below 400 no matter what I tried.
“I think I might have to start you on insulin.”
“Aren’t those injections,” she said ,”and I have to poke myself around my stomach?”
“Well---” I said. 
Before I could finish she said accusingly, “It is all because of your diet.”
“My diet?” I asked bewildered. I had calculated a nice 1500 calorie diet for her based on the family’s normal food intake.
“You told me to eat two iddlies in the morning, , one cup of rice in the afternoon and 2 chappatis for dinner. In the morning, after my pongal and vadai I find it difficult to eat two more iddlies. At lunch time, I have variety rice. Then I swallow your one cup of plain rice with sambhar. “
She must have been eating at least 5000 calories a day!
“What about the morning walk?” I asked.
“How can I walk? Where is the time? I have to cook the families’ food and then the extra diet you have prescribed for me!”
I was bereft of speech.
Another woman with persistent blood sugar level of 375 told me “I eat two iddlies for breakfast lunch and dinner. I love iddlies.”
I was puzzled. Then her daughter-in- law came with her .
“My mother-in-law makes delicious iddlies, “ she said slyly, “I brought two for you.”
I simpered and said, “Oh, you needn’t have.”
Then I saw the iddlies. They had been steamed in a large aluminum strainer similar I usually use to wash vegetables and fruits. They were 9 inches across and two inches thick.

As I started screeching at the patient, the daughter-in-law smirked in the background, preening herself.

Now I have started saying,
“House work is not exercise. You have to walk for 40 minutes on an empty stomach. You cannot eat anything I have not written in the diet sheet. You can eat only ‘cooker iddlies.’
Hope that works!