Many of you are aware regarding diabetes very well.My target audience is general community so there may be oversimplifications.
We know that glucose is an important fuel for our body.Without glucose we cannot survive for long.Excess of anything is bad.
Diabetes is excess glucose in your blood.
How to suspect that you may have diabetes?
1.Remember three P
-Polydipsia-excessive thirst and you drink excessive water
-Polyphagia-excessive hunger and you take more food
2.You have frequent infections in urinary tract
3.You have frequent chest infections
4.Your wound healing takes longer time
How to make sure yourself that you have diabetes?
After your dinner before 10 P.M.don’t take anything except water and in the morning go to your nearest clinical lab and give your blood sample for Fasting Blood Sugar.In your report if its value is greater than or equal to 126 mg/dl you should repeat it one more day,if it is still more than or equal to 126 mg/dl,you have diabetes.Here one thing everyone should know.When we give our sample to lab generally our sample is tested by GOD POD method which takes sometime in reporting.Apart from this some lab for convenience do this test by ready made strips with glucometer.When you get your report,you should check with lab that whether your blood sugar has been checked with GOD POD method or by glucometer strips.Here one thing I want to make clear that there is a chance for false high blood sugar result by strip method and you may be falsely labeled as diabetic.
Further your blood sugar checked by fasting blood sugar or random blood sugar only give you a snapshot value of your blood sugar at that time.There may be many causes of your temporary rise in blood sugar about which we would discuss later.
What you should do if you get two consecutive Fasting Blood Sugar equal to or greater than 126 mg/dl in your lab report?
If it is done by GOD POD method and your value is above 126 mg/dl you should get your blood tested to confirm that you had average blood sugar level was high for the last three month.For this ask your lab to test your HbA1C.If in that report your value is greater than 6.5,your can say that your average blood sugar was high in the last 3 months.One very important point,if you are taking corticosteroids for allergy,asthma,arthritis etc.for long time,your blood sugar as well as blood pressure would be high and it may return to normal if you stop those medicine.Such medicine should not be stopped abruptly,rather such medicine should we gradually tailed off(slowly reducing the dose to lower level over a period of 5 to 7 days then stop).
It is not necessary that the corticosteroids can be found in allopathic medicines only.Beware of ads which claim to cure your asthma or long chronic pains by herbal or Ayurveda preparations particularly in the developing countries where drug control is very poor,because such preparation may contain steroids or be careful of ads relating muscle building formulas because they may contain anabolic steroids.In my opinion you should take the advice of a qualified medical practitioner before going to opt for such preparations.Even if you should take such treatment under doctor’s supervision only.
If you are confirmed that you have diabetes by your blood sugar test and HbA1c test and you have excluded that you are not getting any form of steroids in any form of medication,what should be your next step…..
If you can consult a diabetologist..so much so good!
If you cannot afford to go to doctor by any reason you should know,what else you can do!
1.Increase your glucose consumption by doing exercise,walking,cycling,swimming,gardening,washing your clothes manually,sweeping your house,mopping your house etc.These actions would keep you healthy and off course wealthy.Send all your servants to their native places forever and do all your household work on your own.I am amazed why people go to gym and pay money for their workouts.They burn candles from both sides.You can have plenty of works in your home in which you can cover all your exercise and at the end of exercise your all the work would be done,their all the things would be in place.It is only you who can do your work in the best possible way.Believe me after following my advice you would shed pounds and you would save pounds.So the first principle to keep control on your sugar is burning your glucose by manual activities.
2.Second principle is to spread your food intake evenly in a day.In other words just break your three major meals into six small snacks.Suppose you take usually four chapatis in your breakfast at 8 A.M.,four chapatis in your lunch at 1.P.M. and four chapatis in dinner at 9 P.M.
In that case you should take early morning snack at 7A.M.,second morning snack at 10 A.M.,third snack at 1 P.M.,Fourth snack at 4. P.M.,fifth snack at 7 P.M. and sixth snack at 10 P.M.two chapatis in every snack.
This spreading your daily total calorie intake from three major meals to six small snacks would maintain your caloric requirement of body and would avoid episodes of high blood sugar.
The gist is don’t eat too much at once rather eat small quantities more frequently.
3.Selection of food is also important.You should avoid direct sugar,glucose because they would be very quickly go to your blood within five minutes of your intake and your blood sugar would rise very fastly.Mind it,you have to take those things which would increase your blood sugar slowly.It is a better idea to incorporate sprouts of gram,wheat germs,salads in your snacks because these contains complex carbohydrates and increase your sugar level slowly,apart from this these are rich in dietary fiber which relieves many ailments.
4.You can choose some well known plant products with little or no risk of side effects.
Mostly diabetes occurs in two types.One in which there a chemical called insulin (which is made in your body in an organ called pancreas) is deficient.
Just imagine a building which is made up of bricks,similarly our body is made up of cells.To survive every cell need energy.For energy every cell require glucose as fuel.When we eat carbohydrates like cereals food,it gets digested in our intestines and converted into glucose.From intestine the glucose enters in our blood circulation which is maintained by a pump called heart.Blood functions as distributor of nutrients to all the cells of our body.So the glucose is distributed to every cell of our body.But glucose entry inside the cell is done by insulin.So without insulin the glucose can not enter the cell and it remains in blood and blood glucose level rises.So one type of diabetes which is due to less insulin production is called Type 1 diabetes or Insulin Dependent Diabetes Melitus IDDM.
Another type of diabetes in which insulin is not deficient,but the glucose entry inside the cell is not occurring because cell are not responding to insulin.This is called Type 2 diabetes or Non IDDM.
Imagine a scenario, blood is a carrier which is carrying glucose and an agent insulin which lifts the glucose and knocks the door of the cell.Cell opens the door and takes up the glucose.If the agent is less or absent it will not knock the door of the cell and the cell will not open the door and take up the glucose,so the glucose level will rise in the blood.This happens in type1 diabetes or IDDM.The agent Insulin is less.
Similar scenario in which the insulin or agent is adequate and it is knocking the door of the cells but cell is not opening the door so not taking up glucose.this is type-2 diabetes.
In pregnant ladies body is getting ready to nurse the developing baby in the mothers womb,there is a chemical called prolactin which helps in milk secretion.If this chemical is formed in the mother,this may also give rise to diabetes.(gestational diabetes)
If you are heavy drinker and your pancreas gets damaged by over alcohol intake,you may get diabetes.
If your own steroid production in a glands( which are attached above your kidneys called adrenal gland)is excessive,you may get diabetes.
If you have lung cancer or any other tumor in the body which produces steroids,you may have diabetes.
If your thyroid gland is excessively releasing its hormone,you may get diabetes.
So the ultimate treatment of diabetes is dependent on causes but in many cases no cause is identified.
So for self care my outlined approach,let me repeat…..
1.Increase your physical activity
2.Break your Three major meals to six minor snacks.
3.Avoid simple sugar,glucose to avoid fast rise in your blood sugar
4.You can take artificial sweetener(be careful about that,some sweetener may prove dangerous in long term use.
5.safe plant products like raw bitter gourd juice,blackberry/Jamun seeds powder,methi,ghormar leaves etc.My advice is that,try to arrange any of these things on your own,don’t rely on the ready made products.
6.One important point to note that,many of you believe that taking tea without sugar would not increase your blood sugar,here I want to clarify you that tea,coffee and cocoa all can alone increase your blood sugar by decreasing phosphodiestrase and increasing cyclic AMP and finally increasing blood sugar(you don’t need to remember the names)bad news for all guys who believe that taking tea without sugar will not increase their sugar level in blood their belief is not right.
7.If your blood sugar is not controlled with diet,exercise and herbs,you can go for Oral hypoglycemic agents OHA this is sophisticated name of oral use tablets to control blood sugar.Here a lot of options you have(acarbose,glimeperide,metformin,glibenclamide,gliclazide,pioglitazone,rosiglitazone,rapeglenide etc.) but you are advised to take OHA on your Doctor’s advice only.When you have taken any of these OHA you are advised to take some sweet lozenges or glucose with you so that you can take those when your blood sugar falls.In my opinion most person with diabetes die due to low sugar caused by excessive medication and over control of sugar intake.REMEMBER ONE THING HIGH SUGAR IS NOT SO DANGEROUS FOR YOU BUT LESS SUGAR MAY TAKE YOUR LIFE WITHIN MINUTES,SO THE GOLDEN RULE IS KEEP THE BLOOD SUGAR HIGHER RATHER THAN DANGEROUSLY LOW.
How can any one know that his blood sugar is getting down and he should take some sugar
3.cold hands or feet
4.giddiness or altered consciousness
Apart from OHA, insulin of many types e.g. Regular,50:50,30:70,glagrine can be used only under your doctor’s advice.
DONT EVER TRY OHA OR INSULIN YOURSELF,THESE MAY KILL YOU!MIND IT!
If in your area there is no lab in your neighboring place,you can do self monitoring of your blood sugar with your glucometer,but Its reading is frequently 10-20mg/dl over GOD POD method.you should calibrate your glucometer by giving one time your blood sample to a standard pathos-lab to test your blood sugar by GOD POD and from the same sample you test with your glucometer,compare the results and keep the correction factor of your glucometer in your mind.whenever you test your blood sugar by your that glucometer in your home,correct your figure by correction factor you got in calibration to assess your actual blood sugar level.
Apart from this you can purchase uristix to know your urinary sugar in home.Roughly glucose comes in urine only when its level is more than 170mg/dl,so if your urine is positive for sugar,it means your blood sugar is roughly above 170mg/dl.If uristix is costly,you can purchase Benedict reagent prepared from science lab shops a test tube and a test tube holder.Just fill 5ml of Benedict reagent in a test tube and to it add 6 to 8 drops of urine and heat it for 5minutes,take care the boiling fluid should not be spilled over your body part keep it away from your face.You will see change in color from blue to green to yellow to orange to red to brick red deposits.If color is no change or green…no sugar,yellow +
Brick red deposits++++
Thats all thank you!
To be continued……you need to refresh this page since revision in progress..
For many of you headache is a commonest complaint in your day to day life.This hampers your working potential and many times it is so unbearable that you can enjoy nothing.Even for a clinician it is most challenging to figure out the exact cause without some of the costliest investigations.I am here not for the professionals and my target population is the general community for whom I have dedicated my blog.
Whenever you get headache you generally take NSAIDS(analgesics like aspirin,paracetamol,ibuprofen,diclofenac,nimesulide etc.)sold over the counter.Those drugs help you sometimes relieving your headache as long as their level maintained in blood and sometimes you are simply helpless and nothing is working.
A wide variety of factors are responsible for your headache,it is only you or your primary physician who takes your history carefully can understand the exact cause.In my life I have seen approx 3 lac patients from general community in my life and whatever I have got I would like to share with you.
1.If you are not sleeping adequately,you can have headache.Sleeping is important for your brain to relieve your brain from all the junk files and traces and invalid registeries.When you sleep you tend to clear your RAM by shifting the important contents to your hard disc so after getting up your processing speed gets enhanced.One more beautiful thing of sleep is that, whatever our repressed desire in our mind which overloads our subconscious level in our whole day interaction with society,gets released in the form of dreams we get during REM sleep(In our 90 minutes of sleep cycle there is a stage of approx 25% of each sleep cycle in which there is a Rapid Eye Movement-REM)now the question is ,how many hours should we sleep.In my opinion one should sleep for 8 hours daily.
2.Sleeping is good for your brain but you should take care that the room in which you are sleeping should have proper ventilation otherwise your sleeping would give you headache.Why?You are in a closed room and utilizing available oxygen(We take in oxygen gas and give out carbon dioxide gas in breathing)of that room and increasing carbon dioxide gas in the room which may cause headache.Specially this is common for such people to have headache who live in Air Conditioned room and not running their airconditioner or their air conditioner is such that,it is not drawing fresh air from outside so the oxygen level of that room gets reduced and carbon dioxide gas increased.In kitchen where there is no ventilation,Housewives cooking food on LPG use to consume oxygen of that room on my the burning stove and another by the breathing housewife.If such room has no adequate ventilation the housewife may complain headache due to work in low oxygen and high carbon dioxide level.Further the housewives of low socioeconomic strata burning coal or wood for cooking may also get headache due to inhalation of excessive carbon dioxide generated in the combustion of fuel.If you are sitting in air condition car and your air-conditioner is on but it is recycling internal air of the cabin,it will accumulate carbon dioxide and the oxygen gas would be reduced in the chamber and you may get headache.So you are advised to run your car AC in such mode in which it draws external air but at times when you are driving through a place which is full of dust and smoke you should revert your Car AC in internal air recycle mode.
So to relieve headache one needs good sleep and fresh air and plenty of oxygen.
3.Your eye strain due to any cause may give you headache.If you have some problem in vision,and you require some corrective glasses,and you are not wearing your glasses,you may have headache.
Those persons who are watching TV ,computer,laptop or mobile screen for longer periods may have headache.They are advised to pause such activities and watch some distant object and some near object in alternate fashion.This will be a good exercise for their eyes.After which just close the eyes and gently and delicately massage your eyeball.This would reduce your blood pressure by occulocardiac reflex.
4.When you have not taken any meal for long,you may have headache.Here two complaints together arises first is gas problem,since your stomach is empty and your gastric juice coming in stomach which have nothing to digest so the gas is formed and you may have fullness of abdomen due to gas and headache together apart from this you may experience giddiness due to low blood glucose level in prolonged fasting stage.Your headache can be relieved by carbohydrate rich diet.Further in such prolonged fasting stage your systolic blood pressure may be high due to stress.Your blood pressure commonly recorded and expressed as for example 120/80 in which the 120 is your systolic pressure and 80 is your diastolic pressure.When heart pumps it contracts which is called systole and when it receives blood it expands called diastole so the pressure is expressed as systolic/diastolic blood pressure.
5.Almighty has made our facial bones hollow.There are empty spaces in the wall of our cheek bones,forehead bone and some bones which a common man has not seen behind the forehead bones.Do you know why the almighty has created such hollow bones in our face?This is because the sound produced from our vocal chords gets resonance due to those hollow spaces of facial bones.Those hollow spaces are called sinuses.Those hollow cave like spaces have got only one door for each which opens deep inside our nose.Some times when we are exposed to infection and/or dust which enters our nose and blocks the only door of any of those rooms.All the secretions and bacterias remain trapped there.Those bacteria are such bacteria which grow in the absence of oxygen.They cause damage in those hollow rooms or sinuses and we the doctor say it sinusitis (inflammation of sinuses).This sinusitis is also a common cause of the headache.To relieve such headache apart from the over the counter sold NSAIDS,you need two more things one to take steam inhalation by putting some pain balm like material which contains eucalyptus oils just of the size of a match stick head in one litre of boiling water.This steam would decongest your nose and sinuses and their door would be opened and the contents of the sinus would be drained and two,some good antibiotics like amoxycillin and dicloxacillin combination for at least five days.The dose should be adjusted for weight,age and other clinical condition.warning!all the drugs should be used underguidance of registered medical practitioner only.One more thing I would like to say here,whenever you use antibiotics,you should take one vitamin B Complex capsule also per day for the period you use antibiotics.Because when you use antibiotics to kill the harmful bacteria of your body,it also kill many helpful bacteria in your intestine which make Vitamin B Complex for you.So you may get symptoms of vitamin B complex deficiency if you don’t take the B Complex capsule together.You may have glossitis and stomatitis(inflammation of tongue and mouth).
How steam plus balm inhalation relieves your sinusitis and headache..When the sinus congestion gets cleared,its contents get drained and you feel light headed after steam inhalation.Apart from this the bacteria which grows in absence of oxygen gets killed by oxygen entering in those space after clearance of blockage by steam and the remaining microbes can be killed by antibiotics.
6.If you have any infection in ear you may get headache.Ear has three parts.outer most which leads to a tunnel ends on a thin sheet(ear drum)anything you pour into the tunnel would not go beyond that sheet.Any infection of this external portion can be treated with antibiotic or antifungal ear drops plus oral antibiotic or antifungal medicines.
To be continued…….
Beyond the sheet (ear drum)there is another small chamber called middle ear.This part has also a tunnel which ends to a door which opens in our throat and communicates with our upper airway and food way(pharynx)That door is generally closed and opens when we swallow anything.If you swallow anything while you are lying down this door gets opened and any secretions or material in upper pharynx may enter to the tunnel by gravity and block that tunnel.From that tunnel finally go into middle ear and cause infection and headache.Your middle ear can also get infection from outside if your ear drum is perforated.Your middle ear infection and symptoms may be relieved by NSAIDS,Antibiotics,steam inhalation and what else?Have you chewed bubblegum or chewing gum.I am not joking!You can improve your middle ear drainage by chewing bubblegum or chewing gum while standing or sitting in upright position.This process opens the middle ear’s tunnel door at the time of swallowing of your saliva and helps to drain the tunnels and middle ear cavity under the influence of gravity when you are sitting or standing erect.
7.If your blood pressure is very high,you may have headache.But for the blood pressure to cause headache,generally the diastolic pressure should be greater than or equal to 120 mmHg.To relieve such headache your blood pressure should be controlled to normal level.Many of you may ask,what is considered normal blood pressure?
Normal blood pressure systolic is 100 to 139 mmHg and diastolic 60 to 90 mmHg.If your blood pressure reading comes in above range your blood pressure is normal.One more thing I should add,the pressure should be taken at least 5 minutes of rest in lying down position.Many times when you do heavy exertion,your blood pressure gets increased far beyond the limit specified above,but that increase is for the time being and settles down when you be at rest.Contrary to my above statement there may be inverse phenomena in the atheletes who are accustomed to heavy exercises.
8.If you are a user of tobacco or a smoker you may get headache because of nicotine accumulation in your body.Our brain is suspended in water(called cerebrospinal fluid) within skull bone.We know that when we put any thing in water,its apparent weight gets reduced by buoyancy(an upward force equal to the weight of displaced water by that object)The sheet around our brain which suspends brain into that water is sensitive to stretch and we feel headache if that sheet has greater load or stretching.For that buoyancy the weight of brain which is around 1400 gram is reduced to 400 gm.If the amount of the cerebrospinal fluid is decreased the apparent weight of the brain would be increased.
So the tobacco user or smoker accumulate nicotine in their body which reduces the cerebrospinal fluid,thereby increasing the load on suspending sheet(meninges) of the brain and causes headache.Such headache may be relieved by cessation of smoking or tobacco use for 24hour or longer eo that nicotine level is decreased.
8.Some ladies have headache prior to menses which are generally due to hormonal imbalance.This is better to take guidance from a gynecologist for such headache.One more thing I would like to say the women should not take aspirin for headache at the time of menses because that will increase their menstrual bleeding excessively.Those persons who have asthma,bleeding disorder or peptic ulceration should avoid taking NSAIDS(aspirin,diclofenac,aceclofenac,ibuprofen etc.)In pregnancy also NSAIDS should be avoided.
9.Ladies who are taking oral contraceptive pills may experience frequent headache.For them they are advised to use alternative birth control method.
10.kids experiencing headache should not be given aspirin.
11.Any person who have jaundice or liver disease shouldn’t be given paracetamol.
12,If you have cavities in your tooth or any oral infection,you may get headache.If you cannot afford to go to the dentist and undergo root canal treatment.You can do following:
-Rinse your mouth with chlorhexidine mouth wash for one minutes after each meal.(warning!do not swallow)and spill out the mouthwash after one minute.For fifteen minutes don’t drink or eat anything.After fifteen minutes rinse your mouth with water and spill out.
-Avoid vigorous vigorous brushing to your teeth,rather you should clean your teeth with your finger for few days.
-You can take amoxycillin and cloxacillin combination for your tooth infection in a dose adjusted for your age or body weight(warning !antibiotics should be used under advice of registered medical practitioner only)apart from this metronidazole should be added for better coverage of deep anaerobic infection in your tooth.These should be taken in appropriate dose for at least five days.Here the most important point is,if you have taken alcohol in last 48 hours,you must not take metronidazole at any cost.Further you should avoid alcohol for at least three days after your last dose of metronidazole.
-If you have dental problem you should take calcium and vitamin D3 supplementation,food reach in calcium are fish,particularly its head,if you can chew it totally.Those who are vegetarians the milk and all the dairy products are rich in calcium,custard apple,sitaphal,are also rich in calcium.Those who are very poor to afford this? Don’t worry a millet ragi which is extremely cheap and is one of the richest source of calcium.
10.You may have headache if you are working in area where illumination is very high or very low or inappropriate for that work.That headache can be corrected with proper color combinations of your workplace and application of prescribed luminous intensity in the work area.You can use tinted glass or protective goggles when the things are not in your control.
11.You may have headache if you sit in awkward posture for long or on a chair with poor ergonomic designs.For such headache you are required to do some aerobics for one or two minutes to improve your blood circulation.
12.You can have headache in excessive noise around you which is 85 dB or more.For this you sit relaxed ,put your both palms to their respective sides of the cheek,close your each ear with the tips of your thumb,close your eyes and keep index finger over each eyeball,each middle finger at the sides of your nostrils.Press all three fingers gently and breath in and out through your nostrils and listen to the sounds of breathing for two minutes.You would be at ease.
13.In our brain the pipelines of blood gets stretched on increased pressure in them.This is causes headache and labeled as migraine.There is frequently vomiting and some triggering event by dust,bright light,caffeine or sweets and short acting betablockers or calcium channel blockers are given but you are not advised to take those medications unless and until a qualified doctor has examined you and prescribed you.
14.Brain tumor,brain hemorrhage,meningitis all can give you headache and I am not going to advise you except that it is purely a subject matter of expert doctor and only he can help you.
15.If you believe in acupressure you can give rotatory pressure by your thumb to another thumb for 20 seconds for each side and both the great toes bulge by your one thumb for 20 seconds your headache may be relieved.
16.If you are working in hot environment for long with excessive sweating,you may have headache,such headache can be relieved by taking ors,cold drinks etc and you are required to come to the area where there is less heat stress.
17.If you are in extremely cold environment,then also you may have headache,such headache can be relieved in returning back in normal temperature and getting some hot beverages like tea,coffee,hot milk,soup etc.
18.When you are climbing up at high altitude fastly or descending down from the high altitude fastly,in both the conditions,you may have headache.Such headache can be prevented by gradual ascent or gradual descent to allow your body for acclimatization or adaptation.
19.One more thing that whenever you move from high temperature zone to low temperature zone or vice versa you should stay in intermediate temperature zone for 30 minutes.Such zones are called NT(normal temperature)rooms whose temperature should be the average of high and low temperature zones’actual temperature.
Thank you for patient reading!
Heart attack is scaring word used in common population.Very few of us has clear understanding about this.I want to provide clear message to all of my friends so that they can make a proper judgement about the condition.To understand this you need to to know few basic things.
1.Our all body parts need energy which comes from the burning of glucose.In our body glucose is made by the breakdown products of carbohydrates in our diet.
2.To burn the glucose in our body oxygen is essential which enters in our body when we do breathing.
3.So for obtaining energy for our body we need two things glucose as a fuel and oxygen as a burning gas.
4.Apart from this the most important thing is the transport service.Transportation of essential substances to all the parts of our body is done by blood which is pumped by heart (situated in our centre of chest) through elastic pipes to our whole bodyparts.So there are many pipelines to supply blood to the different parts of our body.And the pumping action of heart is essential for us to be alive. Heart starts beating when an individual is of one month age in mother’s womb and it continues beating till the life persists.
So we know till now glucose and oxygen is important things to survive and heart pumping blood is essential to transport those things to the whole bodyparts.Even the heart wall also needs in own blood supply through main three pipes 1.LAD(Left Anterior Descending Artery) 2.RCA (Right Coronary Artery)3.LCX(Left Circumflex Artery) you don’t need to remember these names.You can compare this with a water pump house of a city which pumps water supply to entire city but the pump house people also need water so they have three pipelines for their own pump house.Similarly the heart pumps blood to the whole body through pipelines and it has got three main pipelines for heart itself.
What happens in heart attack
one or more pipeline (Arteries)gets complete or incomplete blockage due to fat deposition as well as blood clot.
Guess what would happen if blood supply of any area of our body is blocked….Less or no oxygen supply.For this that area would have problem in burning glucose and produce energy.Without energy that bodypart start dying.Such death of a part of body is called infarct.Heart muscle is also known as myocardium so the condition is also called myocardial infarction or MI.
Let us write in a nutshell when any of the artery giving blood supply to the heart wall gets partial or complete blockage the heart wall gets deprived of oxygen which is coming along with blood,the heart wall starts getting damaged and the person feels chest pain (Angina),the outcome depends on blockage extent and other factors we would discuss later.To be continued!
So,I have discussed so far about heart attack;to summarize 1.Heart is a pump which keeps blood circulation to all body parts through pipelines(blood vessels).2.Heart’s own walls also need blood supply which is done via three main pipes( LAD,LCX,RCA).3.There may be blockage in any of the three pipes by blood clot or fat or both which leads to partial or complete obstruction of the supply.4.Blood supply is important for oxygen and glucose delivery since heart needs energy to survive and work and energy is produced by burning of glucose as a fuel and oxygen gas.5.If there is obstruction in blood flow there is mismatch of energy requirement and oxygen availability to produce energy.So in such mismatch caused by partial or complete obstruction the person complains chest pain which is called angina by medical terminology.
when we are at rest there is less energy requirement of body and heart pumping rate required to meet the energy need of the body is less,so the heart’s own energy requirement is also less.So many times when the obstruction of pipes supplying heart wall is partial;the angina can be relieved by rest.
Many persons gets confused regarding chest pain and they get apprehensive that they may have heart attack.I am providing you some insights about this to improve your understanding and clear your doubts.
1.If the chest pain increases on brisk walking, climbing ,dancing or any form of exertion and gets relieved by rest.This may be angina or pain originating from heart.
2.If you can locate your pain chest by single finger it is not anginal pain in the most cases and may be relieved by simple analgesics sold over the counter.
3.If chest pain increased or decreased by change of posture , folding and unfolding at shoulder or elbow joint,it is not anginal pain.Such pains can be relieved by muscle relaxants and general analgesics.
4.Angina is generally dull pain and poorly localized chest pain which appears during exertion or it may appear during extreme emotional stress.
5.Chest pain may appear in empty stomach due to distension caused by gas,such pain is also dull and can be relieved by food ,antacids,h2 blocker like ranitidine or proton pump inhibitor like omeprazole(not safe for pregnant women or children).Such pain would be worse,if you use analgesics like NSAIDS(Non Steroidal Anti Inflammatory drugs like disprin,ibuprofen,paracetamol,diclofenac sodium etc.
Note:Person suffering from diabetes may not have anginal pain and they may just feel chest discomfort or shortness of breathe during heart attack.
Risk factors for heart attack:
1.Smoking -Both active and passive smoking increases the risk of heart attack.
Smoking promotes the blood clottings so there is more chance of blockage in pipe supplying blood to the heart wall.
2.If you have truncal obesity you are at increased risk of heart attack.Truncal obesity means your belley is laden with fat.You can pinch your skin fold at the side of your abdomen and the thickness of fold can be can be assessed by your index finger and thumb.
3.If you are heavy alcoholic you are at increased risk.Though many people argues in favor of moderate drinking,but I opine that people seldom go for moderation those who claim to be moderate drinkers too frequently take heavy drinks on occasions.Further drinking also increases the risk for liver cancer ,peptic ulcer,psychosis secondary to vitamin B1 deficiency.
4.If you have uncontrolled diabetes,you are at risk.
5.If your life style is sedentary and you do not do exercise,you are at increased risk.You should do minimum 150 minutes exercise per week.Be careful in exercise.Don’t do heavy exercise at once.You are required to gradually increase the level and duration of exercise and try to maintain your hydration by taking liquids otherwise your exercise may land you in serious trouble.
6.If in your blood,bad cholesterol level is high and/or good cholesterol level is low you are at increased risk.First of all you need to understand good cholesterol and the bad cholesterol.After the dinner at around 9 P.M.do not eat anything except water.Next morning empty stomach go to clinical lab and give your blood sample for Lipid Profile testing.When you get the report, see the parameters tested
-HDL High Density Lipoprotein
-LDL Low density lipo protein
-VLDL Very low density lipoprotein
-Triglyceride additionally you may get IDL Intermediate density lipoprotein
In all those parameters the HDL is good cholesterol for your heart because it cleans your blood pipelines’fat.Rest all are bad for your heart.
Now the question is how we can increase good fat and decrease bad fat in our blood.
All the animal fats are bad except fat from small fish.
Sunflower oil,safflower oil,olive oil and soyabean oil are good fat.
Palm oil and hydrogenated vanaspati are bad for your heart.
One important message I have to give that the mustard oil is also rich in good fat but be careful about this and do not reheat or reuse the mustard oil after one cooking because it is converted on trans fat which is bad for your heart.
You can easily assess your lipid profile yourself by just checking the normal values of the parameter tested and the patient’s actual value.If the patient value in the report is within the given normal range of that parameter then It is O.K.
To be continued….
7.If you have high blood pressure and you have not controlled it with your life style modification or drugs;you are at increased risk of heart attack.High blood pressure in your pipelines causes your heart to work more against increased load,so the energy requirement of your heart increases,so the oxygen requirement is also increased.Apart from this chronic uncontrolled blood pressure also cause enlargement of heart which can not be reversed back if you control your blood pressure after that change.So person with high blood pressure should keep control on that by prescribed medicine or alternative methods.Medicine choice varies from person to person and your doctor would decide which medicine would be suitable to you.Apart from medicine,there are alot of alternative options for controlling blood pressure.Low salt diet is one option.By low salt I mean table salt that is sodium chloride.One should not take more than 5 gram table salt per day.If you are religious person and believe in fasting and fruit and salt free diet,it may be good thing for you to observe such fast to reduce your blood pressure.You may use natural diuretics like tea or coffee which will cause excessive urination and sodium would be reduced from your blood.
8.If you are a Type-A personality,very much ambitious and restless to achieve your hard goal,you are at increased risk of heart attack.You should do meditation and yoga.Further to relax yourself try to write diary to pour out your thoughts on paper which would release your burdens.Try to live your life in present only.Engage yourself with children,pets and optimistic people.
What would you do,if you are sure that the person is having chest pain or discomfort is characteristic of heart attack?
1.Make emergency call for medical assistance on number applicable to your local area.
2.Relieve his emotional stress by giving him assurance that nothing has happened.Since emotional stress would cause his heart to beat faster leading to increased energy and oxygen demand of the heart.And the situation would be worse.
3.Don’t allow the person to walk on his on.The person should be moved to hospital with least effort from his side.Ideally he should be moved on stretcher by other fellows.Any exertion done by the patient would increase the energy and oxygen demand of his heart and would spoil his condition.
4.Person should have fresh air for breathing,if one can avail oxygen cyllinder,it is a good idea to oxygenate the person in the way to hospital.
5.Some coronary dilater-medicine which dilates the pipelines supplying the heart wall like isosorbide dinitrate 5 mg is used below tongue to relieve the anginal pain.
6.Aspirin can be used as first aid measure if you are certain that the person has got heart attack.Since this prevents the clotting of the blood in the pipeline.
warning!the purpose of this article is educational in nature you are advised to act according to your doctors’advice.
WE ARE HERE TO BRIDGE THE GAP OF DOCTOR AND PATIENT.THERE ARE MILLIONS OF PEOPLE WHO DO NOT GET ACCESS TO THE HEALTH SERVICES.RISING COST OF MEDICAL CONSULTATION FORCES THE COMMON PEOPLE TO BEAR WITH THEIR DAY TO DAY AILMENTS.THEY SEEK ASSISTANCE ONLY WHEN THE DISEASE LIMITS THEIR DAY TO DAY ACTIVITY AND PRODUCTIVITY.OUR EFFORT TO GIVE THEM FREE DOCTOR’S ONLINE CONSULTATION THROUGH BLOG,CHAT OR MAIL.FURTHER OUR ENDEAVOUR IS NOT RESTRICTED ONLY TO ALLOPATHY.WE BELIEVE IN POLYPATHY.TERM CYBERYUKTYPATHY IS COINED BY ME FOR ONLINE POLYPATHIC APPROACH TO HELP COMMON PEOPLE FROM SUFFERINGS I WOULD LIKE TO WRITE HERE SOME COMMON AILMENTS TOPICS. WHICH COULD HELP A LAY MAN TO UNDERSTAND AND DEAL WITH THE CONDITION. I AM GOING TO REPOST ABOUT DIARRHEA.DIARRHEA IS FREQUENT LOOSE OR WATERY STOOLS.
WHAT SHOULD BE DONE IF ANYONE CLOSE TO YOU GETS IT!
1.KNOW WHETHER HE OR SHE IS TAKING SOME MEDICINE PRESCRIBED PREVIOUSLY?
IF YES CONSULT YOUR THE FOR CHANGE IN TREATMENT OR REVIEW.
2.O.R.S.(ORAL REHYDRATION SOLUTION) SHOULD BE GIVEN ACCORDING TO THE REQUIREMENT,ONE SMALL SACHET TO BE DISSOLVED COMPLETELY IN 200 ML(ONE SMALL GLASS) BOILED COOLED WATER OR ONE BIG SACHET IN ONE LITRE(5 SMALL LASSES) OF BOILED COOLED WATER.ONE SACHET FOR ONE LOOSE MOTION ROUGHLY.READY TO USE ORS IS ALSO AVAILABLE IN MARKET. IF YOU CAN ASSESS THE VOLUME OF LOST WATER IN THE STOOL.JUST TRY TO REPLACE THAT VOLUME.
ONE IMPORTANT QUESTION IS IF NO MEDICAL SHOP IS AVAILABLE NEAR YOU OR YOU CANNOT BUY O.R.S. BECAUSE ALL THE SHOPS ARE CLOSED.IN THAT CONDITION YOU HAVE PLENTY OF OPTIONS.1.TAKE ONE LITRE OF BOILED COOL WATER AND TO IT ADD 20 GRAM OF SUGAR OR GLUCOSE POWDER (WHICHEVER S AVAILALE,FIRST PRIORITY SHOULD BE ON GLUCOSE) AND MIX THE SOLUTION THOROUGHLY.ADD 5 GM OF SALT TO THIS SOLUTION AND FURTHER MIX THOROUGHLY.NOW YOR ONE LITRE O.R.S. IS READY.
2.OVERCOOK THE RICE IN PAN WITH EXCESS OF WATER.AFTER COOKING DECANT THAT RICE WATER IN CLEAN CONTAINER.PUT LITTLE AMOUNT OF CUMIN POWDER AND LITTLE AMOUNT OF SALT.THIS IS SECOND HOME MADE ORS.
3.ANY FRUIT JUICE PROPERLY FILTERED FOR PULP AND FIBRE(IT SHOULD NOT HAVE PULP OR FIBRE) WITH LITTLE AMOUNT OF SALT(1/4 TSF) CAN BE USED AS O.R.S.
4. IF NOTHING IS AVAILABLE BOILED COOL WATER SHOULD BE SURELY GIVEN.
APART FROM THE O.R.S.; SECOND IMPORTANT THING IS RESTORATON OF GUT FLORA.HERE IT IS NEEDED TO EXPLAIN YOU THAT IN OUR INTESTINE THERE ARE COLONIES OF BENEFICIAL BACTERIA (I REFERED-GUT FLORA).WHICH ARE SOMETIMES DESTROYED BY THE USE OF ANTIBIOTICS AGAINST SOME HARMFUL BACTERIAL INFECTIONS.BENEFICIAL GUT BACTERIAS DO MANY WORKS FOR US.THEY PROVIDE US SOME VITAMINS AND THEY PROTECT OUR INTESTINE FROM INVASION BY HARMFUL BACTERIA.
TO RESTORE THAT BACTERIA WE CAN USE LACTOBACILLUS SPORES IN THE FORM OF CAPSULE OR SACHETS.IF THER IS NO MEDICINE SHOP AVAILABLE.YOU CAN USE CURD FOR LACTOBACILLUS.
IF THERE IS DYSENTRY(METRONIDAZOLE PLUS OFLOXACIN) COMBINATION CAN BE USED BUT– WARNING-DOSE ADJUSTMENT AND PATIENT HISTORY AND EVALUATION IS MANDATORY.
IN PREVIOUS PARAGRAPHS WE HAVE LEARNT FOR DIARRHEA MANAGEMENT
3.OFLOXACIN+METRONIDAZOLE(DYSENTRY)(UNDER EXPERT GUIDANCE FOR DOSING,AGE OF PATIENT CLINICAL CONDITION OF THE PATIENT.
NOW LET US COME TO..
4.RACEDROTIL IN THE FORM OF SACHET OR PILLS
RACEDROTIL CAN BE GIVEN IN WAERY DIARRHEA @ ONE SACHET 3HRLY OR AS ADVISED BY PHYSICIAN.
5.ZINC DEFICIENCY IS ALSO KNOWN TO CAUSE DIARRHEA.SYRUP OF ZINC IS ALSO AVAILABLE UNDER DIFFERENT BRAND NAMES.ITS USE SHOULD BE DONE UNDER EXPERT GUIDANCE FOR DOSE ADJUSTMENT ACCORDING TO BODY WEIGHT.
6.THERE ARE A LOT OF HERBAL AND ALLOPATHIC PREPARATION AVAILABLE IN THE MARKET TO STOP DIARRHEA BUT THEIR USE SHOULD BE
RESTRICTED AND DEPENDING ON CLINICAL SITUATION.
DIETS WHICH SHOULD BE TAKEN IN DIARRHEA-
1.PLENTY OF LOW FIBER OVERCOOKED CARBOHYDRATES SHOULD BE TAKEN.IT IS A BETTER OPTION TO EAT OVERCOOKED RICE AND STOP CHAPATIS FOR A COUPLE OF DAY TILL YOUR SYMPTOMS GOT RELIEVED.HODGE PODGE(KHICHRI)OVERCOOKED,KHEER MADE OF BEATEN RICE
2.HIGH PROTEIN DIETS SHOULD BE AVOIDED FOR A COUPLE OF DAYS TILL DIARRHEA SUBSIDES.PULSES WATERY PORTION CAN BE CONSUMED.
3.VEGETABLE OF LOW FIBER AND HIGH CARBOHYDRATE LIKE POTATO CAN BE USED.IT IS A BETTER IDEA TO HAVE WATERY HODGE-PODGE WITH MASHED POTATO WITH LITTLE AMOUNT OF HEATED GHEE WITH CUMIN POWDER AND SALT.
4.FRUIT WITH LOW FIBRE LIKE BANA CAN BE CONSUMED.
5.FRUIT JUICE WITHOUT PULP OR FIBRE CAN BE TAKEN.
IF WITH ALL THESE MEASURES DIARRHEA COULD NOT BE CONTROLLED,THE PERSON SHOULD SEEK URGENT MEDICAL ASSISTANCE HE MAY REQUIRE INTRAVENOUS FLUIDS TO CORRECT DEHYDRATION.
TRY TO KEEP VIGIL ON URINARY OUTPUT.IF THE PERSON IS URINATION ADEQUATELY IT IS A GOOD SIGN THAT HE IS BETTER FOR HIS HYDRATION STATUS.
Urinary Tract Infection -Self care and insights
Do you have burning sensations in urine?Every time you go to empty bladder,you still feel urgency but you can void slight only and still feel burning and desire to urinate again?Probably you have urinary tract infection.
How to tackle it if you have no access to a doctor!
know few facts-
1.Your blood is filtered by kidneys and the wastes in the form of urine passes from left and right kidneys via tubes called left and right ureters.Two ureters opens into urinary bladder.When it is full you feel desire to urinate.From bladder a single tube comes out called urethra through which the urine goes out of your body.
2.So you know what is urinary tract.
Right & Left kidneys -> Right & Left Ureters -> Urinary Bladder -> Urethra
Any infection in the urinary tract is called Urinary Tract Infection.
3.The infection goes from outside to your urethra,from urethra to your bladder,and from bladder to ureters,I mean to say in reverse direction.
4.Females have small urethra and their habit of urination is different from males.They urinate mostly in squatting position,so they can acquire infection more easily,if they use poorly maintained public toilets.Because at the time of urination their urethra is very close to the ground which is used by many different people,possibly many of them infected.
5.Those persons who have diabetes have greater chance of Urinary Tract Infection because glucose excess in blood comes in urine in uncontrolled diabetes and glucose provides good culture medium for bacteria.
6.Person having constipation are more prone for the Urinary Tract Infection
7.Apart from above symptoms person can have abdominal pain,nausea,vomiting and fever if the infection is advanced
8..Many of us don’t consult doctor untill it is too unbearable.Okay but you can follow the advice of a virtual doctor who is writing this post.
Simply go to a clinical lab give your urine sample for routine examination.If there is significant amount of pus cell in your urine;get Urine culture and sensitivity test.This test will take 48 hours for your results.In report if any pathological organism found.Check in the report.You will see the name of antibiotics and one two three or four plus sign written against it.Otherwise R(for Resistant) would be written.Any antibiotics with higher number of + can be used in the adequate dose adjusted for age and bodyweight for two weeks.Warning!antibiotics should be taken under qualified physicians guidelines only.
Now what else you can do?If no doctor available,no medical shop nearby…..
Best approach to flush your urinary tract by taking plenty of water.What about the burning sensation.The burning is due to increased acidity of urine.To counter this,you can take alkaline drinks like milk.Any substance which behaves like diuretics(causing excessive urination) like tea,cofee etc. can also help in flushing effect by causing excessive urination.
High fiber diet and plenty of water improves constipation and reduces the chance of urinary tract infection.
BMI is an important tool to assess your health and fitness.
Box at the bottom contains height and weight fields; entering your height in centimeter and weight in kilogram in the table below would calculate your BMI.IF YOU HAVE MEASURED YOUR WEIGHT IN KG AND HEIGHT IN CENTIMETERS SIMPLY FILL THE VALUES IN APPROPRIATE BOXES AND YOU WILL GET THE RESULT.THE RESULT WOULD TAKE A SPECIFIC BACKGROUND COLOR WHICH YOU CAN MATCH WITH DIFFERENT CATEGORY COLORS AT THE BOTTOM.YOU MAY NEED TO SCROLL TO VISUALIZE THE RESULTS.IF YOU ARE OVERWEIGHT,THE BMI RESULT WOULD SHOW THE COLOR INDICATED FOR OVERWEIGHT CATEGORY.SIMILARLY ALL CATEGORIES ARE INDICATED BY THEIR SPECIFICALLY ASSIGNED COLORS.
Many of you are confused with Ideal Weight you should have.This is very easy to know what should be your Ideal Weight.Just calculate your height in centimeter and subtract 100 from that figure whatever you get should be your Ideal Weight in kilogram.
Illustration: Suppose your height is 170 centimeter.
To know your Ideal Weight subtract 100 from your height in centimeter
Your Ideal Weight should be 70 kg.
HOW TO KNOW YOUR WEIGHT REDUCTION TARGET
YOUR WEIGHT REDUCTION TARGET=YOUR ACTUAL WEIGHT-YOUR IDEAL WEIGHT(IF THIS IS NEGATIVE,THAT MEANS YOU DON’T REQUIRE WEIGHT REDUCTION AND YOU HAVE ROOM TO GAIN)
SUPPOSE IN ABOVE CASE IF YOUR ACTUAL WEIGHT IS 80 KG FOR THE GIVEN HEIGHT 170 CM
YOUR WEIGHT REDUCTION TARGET=80-70=10
YOU NEED 10 KG WEIGHT LOSS TO ATTAIN YOUR IDEAL WEIGHT.
APPROX.60 % OF YOUR BODY WEIGHT IS WATER
SO IN ORDER TO REDUCE 10 KG WEIGHT YOUR WATER CONTENT LOSS WOULD BE 6 KG.
THIS IS A MAJOR COMPONENT.YOU CAN REDUCE YOUR WEIGHT BY JUST FAT AND SALT RESTRICTION AND USE OF TEA AND COFFEE AS A DIURETICS.YOU CAN SUBSTITUTE YOUR DIET WITH PLENTY OF FRUITS AND GREEN VEGETABLES AND SPROUTS.
IMPORTANT:IF YOU WANT TO REDUCE YOUR WEIGHT TAKE SIX SNACKS INSTEAD OF THREE HEAVY MEALS AND YOUR SNACKS SHOULD BE CHIEFLY ON ABOVE DESCRIBED THINGS AND DO SOME AEROBIC EXERCISE.HERE I AM STRESSING AEROBIC EXERCISE BECAUSE HEAVY MUSCULAR EXERCISE IS GOOD FOR MUSCLE BUILDING BECAUSE IT INCORPORATES YOUR DIETARY PROTEINS INTO MUSCLE FIBER AND INCREASES YOUR MUSCLE BULK.SO THE WEIGHT LOSS IS MODESTLY ACHIEVED.
MIND IT WHATEVER I SAID IS THE GIST OF WEIGHT REDUCTION.
ONE MORE THING I HAVE TO ADD THAT FIX YOUR SNACKS TIME AND SLEEP AT LEAST 8 HOUR A DAY. THAT’S ALL…………………..
HEALTH FOR ALL VIA ONLINE CLINIC WITH HOLISTIC MEDICINE APPROACH
It is a novel approach to reduce the disease burden in community.Here you can find the topics posted by admin VIRTUAL DOCTOR.You will find the remedies which suits your personalized health needs.Your comments are welcomed.Many people believe in modern medicine,some in naturopathy,some in Ayurveda,some in herbal remedies,some in homeopathy,some in mantra,some in yoga,some in pilates,some in their traditional ancestral methods.First and most important thing is faith in the stream of therapy you are getting.Your healing is anchored to your faith.Faith generates compliance.Compliance gives efficacy.Efficacy alters your system to cure you.Apart from this faith also act psychosomatically to heal you.Further,every individual gets a sense of healing from his total surroundings from which he gains knowledge about the healing methods.Some such knowledge of healing possess scientific foundation,some are based on parental and social teaching which may be misleading.Though the placebo effect of non scientific healing methods is significant.This I have personally observed many times.I believe that everybody is unique and his treatment should be personalized uniquely.Medical science cannot be applied blindly for everyone in a single way.Root cause of symptoms may be organic,behavioral,situational,nutritional,environmental or spiritual.The approach should be appropriate depending on the cause.Even a person presenting with hypertension can be relieved by probing his circumstantial element and releasing his subconscious painful stimulus through counseling.Mutual empathy is must for such counselling approach to succed.Apart from this there may be nutritional habit as the root cause of hypertension.Excess salt intake and accumulation in body also leads to hypertension.For such people reduction of salt in diet would improve his blood pressure.For some other there is lack of adequate sleep may cause hypertension.For such persons taking adequate sleep(at least 8hours per day)can relieve his blood pressure.One of my batchmate who was going regularly in night shift in a hospital.He was diagnosed to have hypertension.Later it was revealed that he was not getting sleep adequately due to his night shift and he got perfectly well when he started taking adequate sleep.If aperson is having any pain in his body which is not bearable can also have high blood pressure.Such high blood pressure can be relieved by relieving his pain.In many cases where a person is getting steroid to relieve his chronic pain can have high blood pressure.His hypertension is secondary to the salt and water retention caused by steroids.Such hypertension can be cured by gradually stopping the drugs.Gradually means tailing off the dose.Here tailing off is important because you should not stop your steroid abruptly.Apart from this,the accumulated salt and water in the body by steroid use can be removed by the use of diuretics.But I don’t suggest you to take medicine without doctor’s advice.Here what you can do is,you can take tea and cofee as medicine or cocoa products which are edible.Those substances act as diuretics(agents that cause excessive urination)and removes salts and water from the body.Further a high blood pressure may be secondary to low blood sugar in such cases there may be excessive sweating,increased palpitation,cold hands and feet and dizziness.Such high pressure can be reduced by giving glucose water,sugar,sweats etc.High blood pressure can also be caused by excessive use of ORS.A person taking oral rehydration solution too much can land into high blood pressure.Such person can be treated by natural diuretics such as tea coffee or chocolates.
So I have cited the example of hypertension.In future you would find many slotutions here.