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Some Health Quaries & Answers

Bundle Of Joy:-

Q: My grandmother wraps up children in a bed sheet all the time so that they cannot move. She says it makes them sleep better.

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A: She is following an ancient practice called “swaddling”. This involves wrapping the baby so that its hands and legs are inside the sheet. Newborn babies sleep better when they are swaddled as it makes them feel they are still in the womb. But this should be discontinued after 10-14 days as the baby needs to move its arms and legs freely to grow and develop normally.

By-pass surgery :-
Q: I am a 58-year-old woman. I underwent hysterectomy at 40. Of late, I’ve been developing a vague chest pain while climbing stairs. I consulted a cardiologist. He did an angiogram and said I had triple vessel block and advised immediate by-pass surgery. A second surgeon, however, said that since I had well-developed collaterals, there was no need for surgery now. He advised revaluation with a stress test every year.

A: I would go with the more conservative approach and not of the knife-happy surgical team. If your collaterals are well developed, you can probably continue indefinitely without a problem. You need to make sure the collaterals stay patent by walking an hour a day on level ground and maintaining your ideal body weight.

Vitamin deficiency :-
Q: I feel very tired all the time. My muscles pain and I cannot eat any spicy food. I went to a physician who prescribed a battery of tests. Finally, he said I had vitamin D deficiency, anaemia and vitamin B12 deficiency. I am only 37.

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A: Vitamin D deficiency is common in India and much of the time it goes unrecognised. It may occur because of our lifestyle (remaining indoors) or it may be a genetic problem. A lot of research is being carried out. The deficiency makes the bones weak and this is reflected as muscle pain.

The stomach contains some cells that are essential for the body to bind and absorb vitamin B12. If those cells are damaged or wasted away, you will not only develop intolerance to spicy food but also adequate amounts of vitamin B12 will not be absorbed. Vitamin B12 is essential for red blood cell formation. That is why you are anaemic.

Your doctor will be able to treat all of this with medical supplements. Once your body responds, your symptoms will disappear.

TV and chips :-
Q: My niece is 10 years old. She is 150 cm tall and weighs 50 kg. I think she is fat. She watches cartoons all day and eats potato chips. Please advise.

A: Being fat or thin is a perception which may be incorrect. You need to find her ideal body weight using the calculation 23 x 1.5 x 1.5 = 51.75 (height in metre squared multiplied by 23). As per the calculation, if you have measured her height correctly, she is not overweight. On the other hand she may have no muscle mass, poor posture and a general round appearance. She does, however, need to curtail her television viewing, stop snacking and become physically more active.

This often involves a change of lifestyle for the whole family. Children learn a great deal by watching their parents and other family members.

Anti-obesity pill :-
Q: I want some tablets to lose weight. All this advice about diet and exercise really depresses me. Exercise makes my body ache and diets make me hungry.

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A: Weight gain and loss are usually gradual processes. When we gain weight, we are probably unaware of it until our clothes become tight and people make unkind remarks. Very rarely do people weigh themselves regularly. For many, maintaining the ideal body weight involves a lifetime of concentrated effort.

Try to control your total calorie intake. Say no to second helpings and avoid fat-filled snacks. Jog, walk or run for an hour every day. That way your body will utilise the food you consume more efficiently.

There are no “weight control” tablets. There are appetite suppressants but they have been banned in India as well as abroad as they were found to cause dangerous, non-reversible, life threatening side effects.

Taking thyroid hormones to increase your basal metabolic rate or steroids to “bulk up” is equally dangerous. Some advertised commercially available weight loss supplements contain these.

Pregnancy puff :-
Q: I have wheezing. I think it’s asthma. I am now pregnant and my doctor switched me from tablets to inhalers. Are they safe for the baby?

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A: Inhalers deliver the medicine direct to your lungs which will help you stop the wheezing. Tablets, on the other hand, enter the bloodstream and go all over the body, including the lungs. Many also cross the placenta and reach the baby. Your doctor is right — inhalers are better.

All answers are given by Dr Gita Mathai , a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at yourhealthgm@yahoo.co.in

Source : The Telegraph ( Kolkata, India)

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Lower Your BP, Live Longer

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In western countries, the number of people affected by high blood pressure (BP) or hypertension is decreasing. In India, however, the figure is creeping up, albeit marginally (2-3 per cent). This is worrying because, untreated, hypertension may result in complications like a heart attack, heart or kidney failure, tearing of the blood vessels and loss of vision. It can also cause subtle loss of memory and the ability to think clearly.
…....click & see
BP indicates the force with which the heart pumps blood against the blood vessel. It has two values — an upper or systolic and a lower or diastolic. Values of 120/80 are normal, while 139/89 indicates pre-hypertension and 140/90 or above hypertension. With age, the blood vessels tend to harden, decreasing their pliability. This causes a peculiar type of hypertension where only the upper value is high. About 70 per cent of the population over the age of 60 has this type of systolic hypertension. BP should be measured every two years after the age of 20 and yearly after 40.

Normal BP:->..
The risk of hypertension increases with age, obesity, a family history of high BP, kidney diseases, diabetes, endocrine diseases, smoking, alcohol consumption, medications like corticosteroids, birth control pills or those for losing weight. Narrow abnormally placed blood vessels present from birth can also lead to high BP. If no cause can be detected, it’s called “essential hypertension” and requires medication to prevent complications. Even isolated systolic hypertension requires treatment.

BP is linked to salt intake. A high salt intake results in elevated BP. The effect is even more pronounced in people (around 20 per cent of the population) who are “salt sensitive”.

The recommended salt intake for a normal person is 5gm or 1 teaspoon a day. But the “hidden salt” must also be considered. All food and even drinking water contains varying amounts of natural salt. Sodium (a component of salt) is added to food products in the form of monosodium glutamate, sodium nitrite, sodium saccharin, baking soda (sodium bicarbonate) or sodium benzoate. These are ingredients in condiments and seasonings like tomato sauce, soy sauce and pickles. Processed meats such as bacon, sausage and ham, and fast foods like burgers and pizzas are high in sodium content.

Medications belonging to groups such as diuretics, alpha blockers, angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, beta blockers, calcium channel blockers and rennin inhibitors are available to control blood pressure. The pharmaceutical industry also introduces “new and improved” drugs in the market with monotonous regularity. Control remains unsatisfactory in many patients who are then dosed with two or more anti hypertensives. The older, long-acting diuretics, surprisingly, remain one of the most effective medications, either as an adjuvant to existing medicine or alone.

Better control of BP with lower doses of medication can often be achieved if the person is willing to make certain lifestyle changes. Weight needs to be ideal. As weight increases, so does the pressure on your artery walls. To calculate your ideal body weight, multiply your height in meter squared by 23.

Inactive people have a faster heart rate, forcing the heart to work harder for longer periods of time. Aerobic exercise like walking, jogging, swimming or running needs to be done daily. It should be started at the age of around six with 20 minutes of running. Gradually this should be increased to an hour by the age of 18 years.

Smoking (even second-hand smoke), using snuff or chewing tobacco releases chemicals into the body which damage the blood vessels, making them narrow and thus increasing the BP.

Salt makes the body retain fluid, which in turn increases the BP. Limit your intake to 5gm a day. Sodium can be balanced by potassium found in fresh fruits and vegetables. Eat four to six helpings of this a day.

Vitamin D obtained through the diet and by exposure to sunlight affects the levels of a BP-regulating enzyme in the kidneys. Inadequate levels can indirectly elevate the BP.

Heavy drinking can cause permanent heart damage. Even two or three drinks in a single sitting can cause the release of chemicals that temporarily elevate the BP.

Stress can elevate the BP. It needs to tackled with meditation and yoga. Chronic diseases like diabetes, high cholesterol, kidney disease and sleep apnoea need to be controlled as they contribute to the risk of high BP.

Children too are at risk from as early as six or eight years if they are obese, inactive and eat high sodium snacks. These lifestyle changes, therefore, need to be initiated from a young age.

You may click to see :10 Ways to Lower Your Blood Pressure Without Medication

Source: The Telegraph (Kolkata, India)

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Help, I Can’t Breathe…

More and more people today are complaining thus, be it summer, monsoon or winter. And it’s not surprising ; the global incidence of asthma is steadily rising. In India, between 5 and 25 per cent of the population is affected. The wide variation is because statistics are difficult to come by. There is very little unbiased documentation about the true incidence of asthma using instruments and lung function tests...…...click & see
click & see
Asthma — now called reactive airways disease — tends to run in families prone to allergy. Some members wheeze, some sneeze while others may have itchy, red skin lesions. Wheezing may be present all the year round with varying degrees of severity. Attacks may also come and go, precipitated by cigarette smoke, chemicals in the air (mosquito repellents, room fresheners), infections (particularly viral), medication (aspirin, ibubrufen) or food additives (dyes, preservatives), with symptom-free intervals…..click & see

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Air enters the body through the main air vessels — the bronchi, which branch out into the lungs as bronchioles. If they are irritated, they secrete mucous which narrows them. In normal people, the bronchioles relax when this occurs so a slight cough expels the obstructing plugs of mucous. In allergic people, the bronchioles constrict further, trapping the mucous and causing a feeling of suffocation…..click & see

Symptoms usually start with a tight feeling around the chest and a cough. But there is no sputum, the cough is ineffective and fails to relieve the feeling of breathlessness and suffocation. More severe, hacking and ineffective cough then sets in.

Doctors do not like to tell a patient or a parent that there is “wheezing” — the latter tend to equate it with asthma and fear chronic lifetime debility. Others confuse it with tuberculosis or primary complex. Neither is true. Wheezing is treatable and the person can lead a normal life.

The mainstay of treatment is bronchodilators, which open up the narrowed bronchi. If a direct delivery system is used, the drug goes straight into the lungs. Nebulisers, inhalers and rotahalors are freely available and efficient. Nebulisers require electricity to work and are not portable. Inhalers and rotahalors can be carried around. Inhalers, unlike rotahalors, require a certain amount of breathing co-ordination to be affective. In young children and the elderly, they become efficient only when combined with a spacer and facemask.

For an acute attack, salbutamol is usually sufficient. If there are repeated attacks, interfering with sleep at night, long-term treatment is needed. There are long-acting medications like salmeterol. When delivered to the lungs, it opens up the airways. This must be combined with a steroid like fluticosone. It prevents the local inflammatory reaction, decreases mucous secretion and helps keep the airways open.

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Tablets and syrups do work eventually to control wheezing. They need to reach the stomach, get absorbed, reach the blood and eventually the lungs. They are more likely to produce side effects like nausea, vomiting and tremors. The onset of action is also slow.

Some lifestyle modifications may help to control the disease. Obesity contributes to the severity and frequency of attacks. The “pot belly” reduces the capacity of the lungs, as it tends to push them upwards. The BMI (body mass index) — weight divided by the height in metre squared — must be as close to 23 as possible.

Aerobic exercises like fast walking, jogging, swimming, skipping or stair climbing improve lung function and capacity.

Avoid known allergens that are likely to precipitate attacks. It may be airborne chemicals, like those in mosquito mats, coils and liquids. These should not be used anywhere in the house, as the smoke tends to permeate easily. Some allergens may be present in food or medication. If an attack seems to be precipitated by ingestion of a particular substance, it’s better to avoid it than search for a cure. Desensitisation is offered in some clinics but it’s a laborious and expensive process.

Stop smoking and as far as possible stay away from smokers.

People with reactive airways have poor breathing technique. This can be improved with exercises taught by physiotherapists and yoga teachers. Videos are available on the Internet. Proper breathing techniques go a long way towards improving lung capacity and reducing the duration, frequency and severity of attacks.

Hand-held devices called spirometers are available to measure the amount of air you breathe in and out. These are inexpensive. By documenting the readings daily, it is possible to anticipate an attack and take prophylactic action.

Always use the nebuliser, inhaler or rotahalor as directed. Sometimes a single dose at night may prevent lung damage and keep the lung capacity at a satisfactory level.

Source:The Telegraph ( Kolkata, India)

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Some Health Quaries & Answers

I want to shed weight fast :
Q: I am getting married in a month’s time and want to lose weight fast. I have to shed six kilos. How do I do that?

A: Crash diets work for short lengths of time, but they aren’t healthy and shouldn’t be continued indefinitely. If you follow a balanced diet of 1,200 calories (60 per cent from carbohydrates, 30 per cent from proteins and 10 per cent from fat), you will have a daily deficit of 800 calories. Once you lose 3,500 calories, you would have lost around half a kilogram of body weight. This means you will lose 3.5kg in a month. Try to combine this with 40 minutes of aerobic activity. That’s a deficit of another 200 calories. The exercise will help develop muscle tone so you don’t have a sagging, aged and unhealthy appearance after the hard gained weight loss.

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Hip surgery:

Q: I have severe pain in my right hip, so much so that I can’t bend. This makes it difficult for me to sit, squat or even walk. I went to an orthopaedic surgeon who advised hip replacement surgery. At 78, I am nervous.

A: Generally, non-surgical treatment with pain relieving medication and physiotherapy is first recommended to reduce hip joint pain, improve joint function and increase the range of movement. Replacement is performed when these have failed. Senior citizens with osteoarthritis who undergo total hip replacement are able to care for themselves, thereby improving the quality of life. Studies have shown that though it is an expensive and invasive process, it is safe. There’s no age limit for hip replacement surgery.

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No rice

Q: I don’t like rice, but am told it’s necessary and without it my health will suffer. Please advise.

A: Basically, 60 per cent of your calorific requirement needs to come from carbohydrates. Rice and other grains aren’t the only source of carbohydrates — they are also found in nuts, dairy products, fruits and vegetables. If you dislike rice, you can switch to wheat or oats. In Western countries, people hardly eat rice yet are healthy.

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Self medication:
Q: I had high fever. I went to a pharmacy and purchased some tablets recommended by the man behind the counter. I now have redness in the groin and armpit, itching and redness in the corners of my mouth. Could this be an allergy?

A: It could be an allergy. Maybe some of the tablets you took were antibiotics. They may have changed your normal bacterial flora so that there is now an overgrowth of a fungus called Candida. You may also have precipitated a vitamin B deficiency. See a doctor to find out what exactly it is. You can then receive appropriate treatment.

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Stretch marks:
Q: I was suffering from polycystic ovarian syndrome for the last two years. I consulted an endocrinologist who suggested regular exercise with medication. Now I have recovered. But I still have reddish marks on my lower abdomen. The doctor had said they would disappear with recovery.

A: The reddish marks on your abdomen are called stretch marks. They develop because of damage to the underlying layers of skin with rapid weight gain. They can be prevented to some extent with regular oiling. Coconut oil, olive oil, baby oils, vitamin E and aloe vera have all been used with some degree of success. Once the marks have developed, oils and creams work slowly over a prolonged period of time.

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Surgical removal can be done with laser treatment, dermal ablation or tummy tucks. This is faster and more successful.

Immunity against tetanus

Q: I want to know about the tetanus vaccine and treatment for the disease. If I take a tetanus toxoid vaccine, how many weeks of immunity would it give? I’ve heard there’s a schedule of three doses (for adults) that gives immunity for three years. Please give me the timetable. If one is afflicted with tetanus, is there any life saving treatment?

A: Tetanus immunisation is provided free by the government to all children. It is given as a combined vaccine with those for diphtheria, pertussis and polio. Three doses are given in the first year and boosters at one, one and a half, five, 10 and 16 years. Pregnant women who have been immunised in childhood are given two doses in their first pregnancy. After the immunisation is complete — that is, up to 16 years — a booster needs to be taken once in 10 years.

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Tetanus is caused by a bacterium called Clostridium tetani, which is found in the human intestine and soil. Once it causes an infection, it releases a poison that binds to the nervous tissue. Spasms of the muscles occur, making it difficult for the patient to swallow or breathe. This can eventually result in death. Individuals have survived with aggressive treatment with artificial muscle paralysis and ventilators for breathing.

Source: The Telegraph ( Kolkata, India)

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Some Health Quaries & Answers

When mamma is at work …..
Q: I am a working woman. I recently had a baby and would like to continue to feed her breast milk. Can I store the milk in the refrigerator?

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A: Expressed breast milk (EBM) can be safely used for your baby. It is safer and healthier than cow’s milk or tinned formula. Wash your hands and collect the milk in a sterile plastic bottle with a tight screw-type lid. Label the bottle clearly, with the date and time, so that the oldest milk is used first. Place the bottle at the back of the refrigerator or in the freezer. Do not mix used leftover milk with fresh milk and use it for the next feed.

EBM can be warmed or thawed by placing it in a bowl of warm water. Do not use a microwave for this. Do not boil it. After warming it, do not refreeze and use again. EBM can be stored in the refrigerator for five days and in a freezer for two weeks. Otherwise, it can be kept in a cool place for six hours.

You may click to see :Breast Milk Storing

Stiff hands
Q: I am 55 years old and drive an hour to work. When I reach my office, my fingers become stiff — fixed in a claw-like position — and can’t be moved easily. I also get “catches” in my leg and chest muscles.

A: You need a check up to see if you are suffering from diseases such as diabetes or hypertension. If so, they need to be tackled. If you are overweight, try to reach your ideal body weight. Walk briskly for an hour and do stretches for 20 minutes before going to work. Yoga, particularly suryanamaskar, is ideal. While stretching, concentrate on the hands. Eat four to six helpings of fruits and vegetables daily. Take calcium supplements. If all this does not help, consult a physician.

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Hernia problem
Q: My doctor said I have an intestinal hernia. What does it mean?

A: Hernias are of many types. An umbilical hernia occurs at or just next to the umbilicus. Incisional hernias occur at the site of a previous surgical scar. Inguinal hernias are commoner in men and occur in the groin area. If the abdominal wall is lax, the intestines can appear to lie just under the surface of the skin, a condition called divarication.

A weakness or deficiency in the abdominal wall present from birth can’t be repaired except through surgery. Incisional hernias and divarication can be prevented by not gaining weight and maintaining abdominal muscle tone with regular exercise.

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Pricking ears
Q: My ears are always pricking. Cleaning them brings out fungus, which forms again becoming worse.

A: The secretion may not be fungus but discharge owing to an infection, allergy or impacted wax. Fungus in the ear causes pain. Allergic or seborrhic dermatitis is more likely to cause pricking or itching.

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You need to consult an ear-nose-throat surgeon to make a diagnosis. Using inappropriate over-the-counter antimicrobial eardrops may make the condition worse. Cleaning the ears may rupture the skin, aggravating the pain and pricking.

 

High BP
Q: What is BP? How can I diagnose and prevent it? What’s the treatment?

A: BP is short for blood pressure. It should be below 140/90. If it is higher, the person is said to have high BP or hypertension. For most adults, there’s no identifiable cause of high BP. It tends to develop gradually over years. Sometimes, high blood pressure can occur as a result of tumours, defects in the blood vessels, kidney diseases or certain medications.

High BP occurs with increasing age, particularly if one or both parents have hypertension. It is commoner in overweight individuals. Smoking or living with people who smoke also increases the BP. Drinking excessively damages the heart and raises the blood pressure.

If you have high BP, stop smoking and drinking. Do regular exercises, combined with yoga and meditation, and reduce your salt intake. Your doctor will be able to prescribe appropriate medications if it does not fall with these simple measures.

The pill
Q: I take pills for diabetes, hypertension and chest pain. I find it hard to have sex. Can I use Viagra?

A: Viagra is a trade name for Sidenafil citrate and is used for erectile dysfunction, which is probably what you have. It is contraindicated in persons with hypertension, stroke or coronary artery disease, and chest pain due to angina.

It is better to discuss the issue with your physician and see if the medicine is advisable for you. He would also advise you on the dosage and time. Relying on the neighbourhood medical shop for supply and advice might be dangerous for your health.

Source:The Telegraph (Kolkata, India)

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