Showing posts with label health. Show all posts
Showing posts with label health. Show all posts

Monday, August 18, 2025

Dil Ki Dhadkan Suno!


The couple were on their annual health checkup round. It was a once in a year routine that they had picked up some two decades ago, and continued regularly year after year thereon. Going to the designated or chosen hospital in the morning by giving up the day's ritual of consuming the regular morning coffee, waiting in the lines before each of the specified counters for registration, drawing of blood, x-ray, scanning, ECG and so on. There would be a line even before the complimentary breakfast counter (though there was nothing complimentary about it as the payment was included in the checkup package!) after the first blood sample was painfully drawn. They called it fasting blood, when actually the patients were fasting and the blood itself did not know about it. It remained red faced even after breakfast.  

He remembered his younger days sitting or standing before the humble radio and listening to the cricket match commentaries. They were indeed wonderful days when each one listening to the radio could have his own imagination of how things went on in the field, unlike todays television viewing when all the millions watching it would see the same thing, and repeat it with each replay. As soon as the first wicket fell, the excited commentator, V M Chakrapani, Balu Alaganan, Pearson Surita or AFS (Bobby) Talyarkhan or someone of the same group (one never knew whether the excitement was genuine or generated only for the listeners) shouted "Chandra draws first blood for India" and so on. Chandra or Prasanna or Venkat or Bedi would draw many more bloods during the day, but here fortunately it was drawing blood only once more. Luckily, health checkup match itself concluded with just two blood drawings. 

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The long waits at each point ended with a short encounter with the dealing staff, technician or doctor, only to adjourn to the next point. This continued till lunch time. The final halt was with a specialist doctor, who would by then have received the final scoresheet comprising the results of the various components of the checkup. By that time the patient would have run of patience, the dealing staff running out for lunch and the specialist himself or herself exhausted with the dose of work for the day. The last available counter staff member was always ready with a helping touch. "If you are tired and hungry, don't worry. Go and have your lunch. You can go home and relax and come back later in the evening. After all, all the tests are done and it is only consultation left now". 

Now the choice was simple. Get out immediately and get in again in the evening. Or, hold on for another hour or so and finish the final painful encounter and be done with it. At the most, it can be one more stop at the hospital's pharmacy for collecting the new tablets prescribed after the new checkup. It is most likely that the pharmacist will say that some of the prescriptions were not available there, though the prescription is by their own doctors. He may even tell you, if questioned about this anomaly, that he just gave away the last strip to a customer a few minutes ago. You are welcome after two days by which time fresh supplies would have come, he would smilingly tell you. Alternatively, you are free to assume that you are the rightful owner of a rare disorder now, as the pharmacy does not have what you need. If you have the courage, try tell the doctor to first check with their own pharmacy and prescribe items that are available there, to simplify the matters. 

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At the door of the specialists cabin, he wanted to check how his wife would like it to be handled. Long years of married life had taught him that it was always "Heads I win; Tails you lose"  while dealing with wife. Better safe than to be sorry, was the unwritten remedy. "Should we go in?", he asked in the language they used at home, knowing well that the people around would not understand it, as it was not the language frequently spoken in that area. 

Before the wife could respond, the voice from inside the doctor's cabin answered in the same language. "Yes. Please come in. I will go to lunch after attending to you". It was divine intervention as the decision was made by someone else. 

As soon as the couple entered the doctor's cabin, the specialist spoke in the same language. She was smiling as they entered the cabin and seated themselves. 

"We also speak the same language at home. It is my mother tongue too"
"Oh, that is so nice"
"There is a murmur in your heart. Did anyone tell you about it earlier?"
"No doctor. I always wanted someone to hear the "Dhadkan" of my Dil in my younger days. No one did. I am glad you could hear at least now!"
"I didn't hear the Dhadkan. I only heard the Murmur"
"Unfortunately, you are professionally trained only to hear the Murmurs"

They all had a hearty laugh. Then other things relating to the consultation went on. They learnt about "Murmur of the Heart" in detail.

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John Milton, considered as one of the greatest English authors, talks of a "Murmur" in his famous sonnet "On His Blindness". When he was confronted with blindness during a part of his life, he wrote that sonnet. "Doth God exact day-labour, light denied?. I fondly ask. But patience, to prevent That Murmur, soon replies....." he goes on. 

Milton's Murmur was in his brain and not the heart. 

"Bhanware ki gunjan hai mera dil...." sang Kishore Kumar for Randhir Kapoor and Babita for the Raj Kapoor production film "Kal, Aaaj aur Kal". The film was released in 1971 and the leading pair got married the same year. It is not known whether the murmur in the heart had a role in the events. 

But the "Murmur in the Heart" appears more for medical reasons than otherwise.

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We all know the purpose of having doors in buildings, furniture  and the like. Doors provide space for movement, getting things in and out as and when desired. Doors can also be closed when not in use and thus protect the enclosed space from unwanted interference. "Closed door meeting" indicates that only certain persons are allowed to participate and undesirable ones are kept away. We have automatic doors that open and close using sensors. This has obviated the need to have "doormen", who were once considered a status symbol. There are doors that open both ways, and the ones that open to inside or outside. There are people who spend lavishly on decorated doors for their houses and offices, though the utility value remains the same. 

There have been many inventions about doors, but the Lord appears to have every type of door in human body! As long as each of them are woking perfectly, one doesn't even remember them. With the slightest malfunction of one such door, all troubles start. From swallowing items in the mouth to keeping one's mouth shut when required, each door has to be working optimally for a healthy life. When there are unwanted deposits behind the doors, they do not open fully and thereby result in bringing down the efficiency of the respective parts in their function.

Some of these doors are in the heart. Some are called valves. Heart has chambers. The doors of these chambers keep opening and closing in a rhythm, allowing for blood to fill a chamber, and once filled push it out with force so that it can reach different parts of the body. Sometimes these doors and valves do not work properly. Experts identify many factors for such issues; ageing, life style, disorders from the time of birth itself and so on. When the doors or valves do not open fully and blood flows in the restricted space, it comes out with a hissing noise. A heart murmur is defined as a whooshing, blowing or rasping sound heard during heartbeats. 

Valve Stenosis is such a condition when there is murmur which can be heard by the doctor using a stethoscope. Experts can even identify it without stethoscope in many cases. Doctors classify these stenosis cases as mild, moderate and severe. Severe stenosis diminishes quality of life due to feeling tired with even little exertion. Modren science has provided many surgical interventions to improve the conditions.

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There were many cases of deaths of relatively young in age due to heart issues in and around Hassan in Karnataka recently. Some even went to the extent of blaming it on the vaccination during Covid times. Experts have since clarified that this is not the reason for the deaths. However, there are many sudden deaths when youngsters are working out in Gyms, and many others with apparently no clear reason. 

There is a reluctance on the part of many around us to have a medical checkup and seeking expert advice. It basically stems from the fear that approaching a medical professional leads to even more complications and wasteful expenditure. This approach leads to many more troubles. "Bhavitavyam Bhavatyeva" (whatever is going to happen, will happen!) is not a solution. Heart murmurs can lead to giddiness, fall and even strokes. Timely intervention avoid these dangerous consequences. Strokes result in serious impairment of quality of life and results in many different types of troubles for the person, as well as near and dear ones. 

*****

Listen to the heart! Dil ki Dhadkan Suno. That "Murmur" is not to be ignored. 

Sunday, December 22, 2019

Are You Really Fit?



One of the hot topics being discussed in various gatherings nowadays is physical fitness and healthy habits. A lot of emphasis is laid on morning walks and going to the Gym. Friendly neighbourhood parks are being equipped with Air Walkers and Mini-Gyms. Yoga clubs are brimming with new members and started working out in shifts in these parks. Publication of varied views on use of Coconut oil and Olive oil on the one side and consuming Millets on the other, can be found in all reading mediums and videos. Some of these grains were uncared for two years ago, but have reached their life time high prices now. Multi-Millet Dosas and Bisi Bele Bath have caught the imagination of fitness freaks. Coconut oil was considered as villain some time back but has now come back into circulation with a vengeance. A half litre bottle of "VIRGIN Coconut Oil" now costs Rs. 375 and yet is in great demand. 

Diagnostic units have started coming to houses, collect blood samples etc. and dispense reports online. Preliminary checkup camps are seen in public parks frequently. Ayurveda and home medicine aids have found acceptance once again. Tablets and tonics are available at great discounts when bought on the net. Charges for Annual Health Checkup packages are being revised upwards every year. Anything can sell now under the name of fitness aids. Overall, it is a wonderful time for reviewing one's own fitness, whatever fitness may mean. Today fitness finds similarity with The Supreme, as each one sees it in his/her different way.

It is in this background that two recent news items draw our attention. One is indeed alarming while the other is a success story of a startup. Both are interesting for different reasons and deserve some discussion in the context of fitness programs.
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EduSports is a Bengaluru-based organisation working for implementation of programs on physical education and sports in schools. A recent study conducted by this organisation has brought out that the present generation of schoolchildren in India seem heading towards an unhealthy future. This is so among all age groups and no gender bias in this. The study covered more than 100,000 children aged between 7 to 17 years in 287 schools across the country, in 85 cities and 23 states. The fitness levels were indeed alarming at all levels. The assessment included anaerobic exercise capacity, flexibility, lower and upper body strength and body mass index (BMI). Nearly half the children lacked a healthy BMI and endurance which is attributed to lack of physical activity and outdoor games.

Children in all the regions of the country were found equally unfit with average BMI of about 40 per cent. Children in rural areas were slightly better off than their counterparts in cities. Modren amenities are taking its tolls in cities as it seems. Nevertheless, such high unfitness levels are indeed a serious cause of concern. Addiction to video and mobile games and lack of outdoor activity is identified as the prime reason for this state of affairs. There are also reports of diabetic cases from the younger age groups as well. Fit India Movement has indeed a daunting task before it. 
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Fitbit is a 12-year old San Francisco based company dealing in health and fitness based  products. Started in 2007, the company announced last month (November 2019) of it being acquired by Google for 2.1 billion US Dollars. The company's two founders realised that the tremendous advancement in sensors and wireless technology can be used to bring in amazing experiences in fitness and health. A wearable product coupled with modren technology can produce fantastic results, they thought and worked in that direction. Today more than 28 million users of Fitbit products allover the world have made the company grow to such levels. The company manufactures various products for monitoring fitness activities and provide multi-dimensional data to users about their fitness activities and analysis. It has so far sold over 100 million such products.

There are many other companies selling similar fitness monitoring products. The cost of such wearable product, most of them replacing wrist watches, varies from Rs. 2000 to Rs. 15,000 (US Dollars 30 to 200+) and can be purchased online as well. These devices provide many streams of data to the user on a continuous basis. The devices are connected generally to a mobile and data can also be accessed on laptops. Wireless technology provides for real time updating the user's activities for reading and arriving action points. The devices also provide links to articles and blogs that give enhanced learning points and assist in understanding and analysing one's physical activities. 

While these devices draw and process data from the user on their own in respect of certain parameters, they also provide for manual feeding of certain types of data which the devices cannot measure on their own. The devices are expected to be used round the clock but allow manual feeding of data if it is not on the body of the user for some reason. Data relating to consumption of liquids (volume), food items (calorie values), weight gain or loss etc. can be fed manually as the devices would not be able to measure these parameters. However, data relating to number of steps walked or distance covered, number of floors climbed, calories burnt during the day, number of active minutes, pulse or heart beat rate (not BP) etc. are measured by the device itself.

These devices have readymade fitness parameter programs a user can choose from. They also provide for a user to customise one's own fitness programs suiting individual requirements. Devices provide encouraging inputs when some goal is in sight even if the user loses sight of due to other preoccupations. "Only 120 steps to go!", "You have conquered one more frontier", "Overachieved your goal!" are examples of such messages. A weekly summary of the activities and comparing the data with the previous week's achievements is also available. For further encouraging the users, companies send badges for crossing some milestone under each parameter. Users can also form their own groups and share the data to encourage each other which may find fancy with the younger age group users.
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What are the measurable data that help in evaluating a fitness program? What are the basic goals suggested by these devices? How would it help the user?  Are these plans really practically possible or wishful thinking? Is it not possible to go through a fitness program without using such devices? Are not these devices only money making tools for those manufacturers? Is it not possible to be disciplined without use of such tools? These are the most likely questions that may emerge out of fitness device discussions. 

The following points give an insight into these queries:
  1. Number of steps traveled in a day is a major parameter. 10,000 steps a day is the suggested minimum as this translates to about 5 miles for most of the people. The steps also depend on the occupation of the person. A waiter or a nurse takes many more steps in a day than an office worker or at home person. The average steps for a person in India is said to be about 5,000. A program with 10,000 steps gives a fillip to fitness initiatives. 
  2. Number of stairs climbed during a day is another indicator. The devices track such movements on their own. This goal helps in avoiding waiting for elevators even for one floor and improves blood circulation in the legs.
  3. Distance covered by walk is another goal. This happens simultaneously with the number of steps. 5 miles a day is the normal suggestion.
  4. Number of calories burnt during the day is another major goal. A person burns about 1,500 calories a day even when remaining inactive due to functioning various organs and activities like breathing, eating, digesting etc. A goal of 2,500 calories per day would improve the fitness level. This can be increased further according to individual requirement.
  5. Number of continuous active minutes is another major parameter. A minimum of 30 active minutes a day like walking, running or outdoor play etc. is suggested.
  6. The devices also recommend taking some 250 steps each hour for periods ranging from six to nine hours each day. This provides movement on regular basis especially for office workers and those spending long hours before computers.
All the above goals can be modified according to individual needs. Device manuals and websites provide many more activities and suggestions to choose from.  
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One important watchword in any management jargon is "Anything that cannot be measured cannot be improved". Are there any real benefits in using such devices? There certainly is if they are regularly used and not thrown in a corner after initial euphoria of the first few days. Regular usage brings lot more discipline in managing one's fitness. Many users have benefited by reducing blood sugar levels from 30 to 80 points as well. 

What are the deficiencies in such devices? There are many. One common observation is that steps taken when the hand wearing the device is not moving are not counted. Similarly, mere swinging of hands also count as a step even if the person is actually sitting in one place. Travelling in a fast moving vehicles or rough roads also runs up step count or stairs climbed. There are other objections as well. 

While there are certainly some merits in the objections to the usage of devices due to such events, the benefits of their use far outweighs the drawbacks. One can use the device on trial for a few days (may be by borrowing from an understanding or obliging friend or relative!) if necessary.

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An interesting piece of information that came out while preparing for this blog post is about Cardio Fitness Score. It is an estimate of VO2 Max, which is the maximum amount of oxygen one's body can use during exercise.

A VO2 score of around 40 to 45 is considered excellent for a normal person. This of course depends on the age, height and weight of a person. Trained athletes have much more VO2 scores. The devices suggest the likely improvements in this score with reduction in weight for overweight persons. Ryan Hall, US Marathon Record Holder has a VO2 score of 81. How does Rafael Nadal muster strength even while fighting in the 4th and 5th sets of a Grand Slam event? Many top sportsmen, and tennis players included, have wonderful VO2 scores. Constant training improves and enlarges their hearts so that they can hold and pump more blood to meet the needs of heightened activities.

Nadal has a VO2 Max score of 85 and his pulse rate can go up to over 200 as against an average of 60 to 70 and a maximum of 150 for most people. Thus he can still hold the energy to win a point from hopeless situations and finish longer rallies when his opponents are gasping for breath. This is not a surprise when you watch him on the court!

Saturday, January 13, 2018

Water In The Vessel

We all desire to have comfortable days, day after day. No one likes to have difficult days, one after the other. Not only a bad day one after the other, but not even a bad day amidst many good days. The want is to always have happy days and thereby enjoy life. Comfortable days with good health, lot of money and all other things that we want. We do not want even the streaks of anything that we perceive as bad amidst plentiful good tidings.

Desire is one thing but the reality is something else. If everything turns out to be the way we want, there would be no problems in life. It never happens that way because we are unable to control many things. If we contemplate further, we are unable to control even things that are apparently under our control.

Sufferings may be of different types. Financial sufferings can be one of them. There are times when all the hard work done does not result in financial benefits. There are instances when hard earned money is lost due to unforeseen happenings. Trusted friends and relatives borrow and fail to return when needed by us. Friendship is lost with money lent. Previously made out plans are now upside down. Many times new beginnings have to be made at later stages in life. These turn out to be painful and frustrating times indeed.

Loss of social status can be another cause of suffering. Loss may occur due to one's own failings or due to mechanisation of trusted ones. Many times retrieval of the lost status may not be possible. Some are able to get on with life in changed circumstances; others suffer in the very thought of having lost in the race.

Physical health is another important issue in life. One may ignore financial loss or social status being taken away. But setbacks in health is something which is very difficult to ignore. The problem continues to haunt during days and nights. It comes with us wherever we go. If the loss of health is coupled with pain, then it is even more miserable. Pain killers are temporary relievers of pain; they have their side effects too. Fighting pain and still carrying on daily activities is indeed very testing and demanding.

We see many people around us who suffer setbacks in health. There are some who cannot come out of the setback and succumb to the difficulties. We also see many others who are brave and fight their way out of trouble. These are the people who show remarkable tenacity amidst very adverse conditions. They do not give up even when others around give up hope. They are the examples of exemplary bravery and astonishing resilience. Watching them fight it out and come out successful inspires others.
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An young man entered his office in the morning as usual. "Are you not feeling well?", The first colleague he met near the door asked him. "No. I am fine", he said and started his work. Another colleague came and asked him why he did not take the day off as he looked sick. The young man ignored and went on with his work. Another three or four colleagues had the same question and now he started getting doubt about his own health. He went to the rest room and checked his face in the mirror. He felt he looked tired and not normal. By afternoon he developed high temperature and felt very sick. The prank played by his colleagues had indeed taken its toll.
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Psychologists say that there is a direct relation between physical health and mental health. State of mind plays an important role during sickness and recovery to good health. Pain and physical suffering have their impact on mental status of a person. Similarly, a disturbed mind acts on physical health.

Though physical health and mental health are inter dependent and affect each other, the effect of mental status on physical wellbeing appears to be even more significant. One important attribute that can be seen in those who fight physical adversity is their healthy mindset. They remain to be cheerful even amidst physical pain and suffering. They do not resign to their fate and believe in combating the troubled days and emerge victorious. This could even be seen the way they interact with those around them. It is this mental strength that sees them through the physical pain and suffering. 

On the contrary, we have many examples of mental weakness amplifying the physical troubles. People attending to the sick know this better than others. Brooding over the difficult things mentally directly impacts physical wellbeing. Mental troubles increase physical pain and suffering. A healthy mind is indeed a strong tool to restore physical health.
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All this discussion is well summed up in this verse from Aranya Parva of Mahabharata:

मानसेन हि दुःखेन शरीरमुपतप्यते |
अयःपिण्डेन तप्तेन कुम्भसम्स्थमिवोदकम् ||

Maanasena hi dukhena shareeramupatapyate |
Ayahpindena Taptena Kumbhasamstahamivodakam ||

Physical body suffers due to mental disturbances. Just as the water kept in a vessel gets hot when the vessel is heated. 
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The relation between the mind and body is like the vessel and the water in it. Even if the water is not heated directly, the heat of the vessel results in the water becoming hot. Therefore, all efforts should be made to keep the mind cool even in times of adversity. This ensures that the body remains healthy at all times. This is all the more important when the body suffers pain. A calm mind reduces the effects of such pain whereas a disturbed mind would only increase the pain and suffering.