Saturday, December 8, 2018

manage pain



Tricks to manage pain
Rhythmically tapping a part of the body that is away from the area of the pain confuses the brain
By Dr Gita Mathai
There is a myth that we use only 10 per cent of our brain, but actually we use most of our brain almost all the time. It functions tirelessly, 24 hours a day, whether we are awake or asleep. It performs complicated sequential actions, some physical (those performed by an expert juggler), some mental (complex mathematics) and coordinates thinking and movement. All activities, conscious and subconscious, performed by humans are under the centralised control of the brain.
With advancing age, brain cells die, leading to loss of function, physical prowess and memory. The good news is that neurogenesis — the formation of new neurons — also occurs. It occurs naturally rapidly in children but reduces in adult life.
It really slows down in older people unless active efforts are made to form and maintain new connections. This can be done by learning new skills — such as dancing, a different language or a musical instrument.

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Adults tend to accelerate the rate of destruction of brain cells with inappropriate lifestyle habits such as smoking, uncontrolled diabetes or hypertension, or working with volatile aromatic compounds such as glue. Of all the lifestyle poisons, controlled alcohol consumption — not more than one “small” drink a day for women and two for men — is the least harmful.
Incidentally, it is possible to control some subconscious brain functions, such as the perception of pain, by tricking the neurons. All of us feel pain at some point of time. If it is an episode of acute pain, it can be tackled with medication but chronic pain is a different story. Arthritis and other painful diseases can take over our lives, preventing efficient functioning. Although pain arises in specific areas of the body, it is processed and felt in the brain. And it is possible to trick the brain into thinking that the pain has disappeared or lessened. Here’s how:
Apply ice for 5-10 minutes to the area of pain. Then rhythmically tap a part of the body that is on the side opposite or away from the area of the pain. The conflicting signals confuse the brain and there is an “override”. The pain reduces in intensity. The dose of painkillers can also gradually be reduced.
Listening to music lessens the perception of pain as the auditory sensory signals override that generated by the pain. Meditation and repeating mantras also helps.
People sometimes have an uncontrollable itch in a part of the body. If there is no discolouration or swelling, it may be a kind of neurogenic itch . That too responds to ice packs, followed by rubbing the opposite side of the body. This manoeuvre is even more efficient if it is done seated in front of a mirror.
Insomnia — the inability to fall asleep and stay asleep — is the plague of the 21st century. It aggravates a plethora of diseases, such as diabetes and hypertension, and contributes to weight gain. In addition to exercising in the evening (only until 7pm), going to bed at the same time every day in a darkened room with no plugged-in electronic devices and drinking a glass of warm milk before bed, you could try the 4-7-8 method.
Place the tip of the tongue behind the two front teeth, exhale completely through the mouth while making a sound for a count of eight. Inhale through the nose for a count of four and then hold your breath for a count of seven.Repeat three times. This works miracles, without the aid of addictive sleeping medication. Sweet dreams!

The writer is a paediatrician with a family practice at Vellore and author of Staying Healthy in Modern India.
If you have any questions on health issues please write to yourhealthgm@yahoo.co.in



Saturday, November 24, 2018

travellers diarrhoea

Travelling? Take precautions for traveller's bug

Unfortunately, 40-60 per cent of travellers are prone to sundry infections
By Dr Gita Mathai
  • Published 21.11.18, 1:51 AM
  • Updated 21.11.18, 1:51 AM
  • 2 mins read
  •  
Viruses from the enterovirus and rotavirus family, bacteria, especially E.coli and protozoa-like giardia can cause traveller's diarrhoeaImage: Wikimedia Commons
The holiday season has started and elaborate plans are being made for pilgrimages, trips to holiday resorts and visits to exotic locations. Unfortunately, 40-60 per cent of travellers will be exposed to disease-causing “bugs”, which result in sundry infections. Of these, 'traveller's diarrhoea' is the most common and incapacitating. It forces sightseeing and travel to be put on hold, as the search for a toilet becomes a priority.
The diarrhoea usually sets in within two to seven days of travel. It is watery and may be associated with other symptoms like nausea, vomiting, abdominal pain and urgency. The good news is that it is self-limiting. It usually subsides within two or three days with or without treatment. One of the critical features of the traveller’s diarrhoea is that local hosts are immune to it. Their intestines have developed resistance over the years to the offending organism.
Viruses belonging to the enterovirus and rotavirus family, bacteria (especially E.coli) and protozoa-like giardia can all cause traveller's diarrhoea. In 70 per cent of the patients, no one agent has been found to be responsible. There is therefore no universal cause and no common cure.
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Although the disease is self-limiting and usually subsides on its own, it is essential to prevent complications like dehydration. Fluids, such as correctly reconstituted, commercially available packets of ORS (oral rehydration solution), homemade ORS (1 litre of water, 1/2 tsp salt and 6 level tsp of sugar), salted rice gruel, khichdi, bananas, lightly salted buttermilk and lime juice with sugar and salt can be consumed for hydration. Alcoholic drinks and caffeinated, carbonated beverages are not recommended. It is also best to avoid milk. Keep in mind that rehydration will not reduce the frequency or quantity of the stool. It will only prevent complications.
The frequency of diarrhoea can be reduced with anti-motility agents such as loperamide (imodium). More than 4-8 tablets should not be used as it can cause dizziness and bloating. These tablets are not advised for children under six years of age. Antibiotics are not routinely prescribed, as often the diarrhoea is due to viruses or protozoa which do not respond to these medications. Also, inappropriate antibiotic treatment does not reduce the frequency and duration of diarrhoea. It is only likely to produce side effects like monilial overgrowth and resistant organisms. Superinfection with some of these organisms can be life-threatening. If the diarrhoea persists for seven days or more, antibiotics may be required with a medical consultation. A short three-day course is usually sufficient. Taking random antibiotics before travel to prevent diarrhoea will also not work.
If the diarrhoea persists for 10 days or more after travel, it needs to be investigated. If it is associated with belching, bloating and large unformed stools, it may be due to giardia. If there is blood and mucous, organisms like shigella or cryptococcus may be responsible. If the diarrhoea persists a month or more, and no infectious agent can be found, it may be due to a non-infectious cause or a complication that has set in, such as IBS (inflammatory bowel disease) or milk allergy.
Here are precautions you can take to reduce the likelihood of diarrhoea —
  • Drink only boiling hot tea or coffee. Avoid juice as ice used in it may not be sterile.
  • Drink bottled water or water that has been boiled for three minutes. Even teeth have to be brushed with bottled water in some countries.
  • Avoid cut fruits and vegetables such as in salads.
  • Some diarrhoeas due to rotavirus, cholera and typhoid can be avoided with timely immunisation.

Saturday, November 10, 2018

bringing up a child

https://www.telegraphindia.com/health/why-discipline-is-important-for-your-child/cid/1674194?ref=health_health-page

Why discipline is important for your child

Many parents these days are clueless about how to bring up a child
By Dr Gita Mathai
  • Published 6.11.18, 9:43 PM
  • Updated 6.11.18, 9:43 PM
  • 2 mins read
  •  
Stuffing food down a child’s unwilling throat is a recipe for disasterImage: Wikimedia Commons
Many parents these days are clueless about how to bring up a child. There is no support from a rambling family — grandparents, widowed aunt, unmarried uncle — and domestic help is not only hard to get but also unreliable. That is a huge problem for working mothers.
Feeding the child — when and how much — usually becomes an area of conflict. Parents often have unrealistic expectations but stuffing food down a child’s unwilling throat is a recipe for disaster. And starting the day with a glass of milk — especially one fortified with protein powder — is not a good idea. It fills the stomach, suppresses appetite and provides a sense of satiety which often stays the whole day, making the child refuse breakfast.
Instead, start the day with exercise. Let the child run on the terrace or in the garden for 20 minutes and then get him or her ready for school. Keep at least 30 minutes in hand for breakfast. Feeding the child because “there is no time” will lead to retching, vomiting and refusal of food. Meals need to be savoured, this takes time. There should be a fixed place for eating — in front of the television, iPad or mobile phone results in mindless eating, obesity and lifestyle diseases in later life.
Regular exercise is a must. Twenty minutes of aerobic activity morning and evening goes a long way towards improving memory, productivity and helping the child fight fatigue. It is a good idea to put the child into structured sports training or martial arts. Such children are less likely to experiment with smoking, drinking and drugs. They are also less likely to be hooked on to the Internet, suffer acute depression or attempt suicide.
There is a lot of misinformation in the media about immunisations. These injections have been developed to protect children from disease. It is necessary to immunise against diphtheria, pertussis, tetanus, polio, H. influenza, pneumococcus, rotavirus, hepatitis B and A, flu (every year), typhoid (every three years), chicken pox, measles, mumps, German measles and HPV (human papillomavirus). Some of these diseases can be fatal or leave the child with lifelong disability. Polio can cause paralysis of limbs, mumps sterility, chicken pox deafness and blindness, hepatitis B permanent liver damage, H. influenza and pneumococcus brain fever and ear impairment.
Children can be demanding, but they lack the maturity to discern between good and bad. Therefore, parents should not always give in to their requests. The approach to a child should be consistent, firm, affectionate and authoritative, not authoritarian. If something is “no” then it should remain so despite temper tantrums, pleading and “recommendations” from grandparents.
We tend to support our children and give them a sense of entitlement to opportunities they do not deserve by bending rules and paying bribes. If parents do not obey rules, they cannot expect their children to do so. (A typical example is the crash helmet rule.) Pushing them into unsuitable professional areas because of parental pressure and bribes results in failure and frustration.
Children who lead a disciplined, orderly life and are allowed to develop their interests are likely to become successful in their endeavours and realise their potential. Children who are trained to be diligent, methodical and have self-control are more likely to grow into happy adults than their careless or undisciplined peers.
The writer is a paediatrician with a family practice at Vellore and author of Staying Healthy in Modern India. If you have any questions on health issues please write to yourhealthgm@yahoo.co.in

Thursday, September 6, 2018

looking fat

Yes, you do look fat

Your Health

People - young and old, male and, mostly, female - ask friends, relatives and physicians, "Do I look fat?" Often, the honest answer should be "yes". Visual perception of weight (thin, okay and fat) is usually correct. It needs to be backed up by scientific measurements for accuracy.
At present, 14.4 million Indian children and 30 million adults are obese. This is an unseen, unrecognised and dangerous epidemic. Part of the problem lies in our culture - we equate a potbelly with prosperity, like plump children and curvy women with a BMI around 30.
People sometimes ask, "Am I the correct weight for my age?" While weight does tend to creep up with age, especially in women, your ideal weight depends on your height, not your age. It needs to be measured scientifically.
The BMI (body mass index) is weight divided by height in meter squared. It should ideally be around 23 and, preferably, under 25.
Waist circumference should be 102cm (40inches) in men and less than 88cm (35inches) in women. In the Indian context, this has been brought down to 31inches in women and 37inches in men.
The waist-hip ratio (circumference of the waist divided by that of the hips) should be less than 0.9 for men and 0.85 for women. In children, the value is less than 0.5.
Body weight usually increases because of fat deposition. There can be all-over deposition of fat under the skin, which produces a pear shape with big hips and thighs. There can also be accumulation of visceral fat in the abdomen, around the internal organs. This creates a "beer belly" or "muffin top" and unsightly "love handles" hanging down the sides of an apple-shaped body.
Visceral fat is dangerous because it acts as an organ and secretes hormones called adipokines. These contribute to a variety of diseases such as deranged lipid profiles, Cushing's syndrome, polycystic ovary syndrome (PCOS), glucose intolerance, insulin resistance or diabetes, early onset of osteoarthritis (especially the knees) and Alzheimer's. The fat also gets deposited in the liver, causing it to enlarge and get damaged, becoming a "fatty liver".
Getting into shape is not easy. Crash diets, "fat-free" meals, meal-substitute shakes - in other words, severe caloric restriction - can initially cause dramatic weight loss. The body then adapts, goes into "famine" mode and starts to conserve calories. The weight stabilises for a while and then slowly creeps up.
It is better to eat healthy, restricting your intake to 75 per cent of your regular diet, avoiding high-calorie, trans fat and sugar-laden snacks and eating 4-6 helpings of fruits and vegetables a day. This way the weight not only melts off - though slowly - but is likely to stay off.
Visceral fat is more likely to respond to a combination of diet and exercise rather than calorie restriction alone. "Cardio" or aerobic exercise such as running, jogging, walking, cycling, dancing or swimming for 40 minutes to one hour a day is ideal. Dancing has the added benefit of maintaining balance and coordination and delaying the brain changes linked with ageing. If you cannot spare a 40-minute chunk of time everyday, four sessions of stair climbing for 10 continuous minutes or even a two-minute brisk walk every hour during the day is beneficial and will help.
Muscles increase the BMR (basal metabolic rate). The higher the BMR, the more calories a person burns, even at rest. So build more muscles and maintain the ones you have. (You lose muscles with age.) Do a set of muscle-strengthening excercises with light weights every alternate day along with your cardio workouts.
The writer is a paediatrician with a family practice at Vellore and author of Staying Healthy in Modern India. If you have any questions on health issues please write to yourhealthgm@yahoo.co.in
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