Living with chronic acne and my Sotret experience

If you read through my blogs you will know how paranoid I am with my chronic acne condition. It’s been there since my preteen days and never quite left me. I could always relate to those commercials that had a pretty girl, with a forever surprising look, who wakes up every morning to new breakouts. That was exactly my story (except the pretty part) but sadly no OTC med could cure me of my breakouts totally. In subsequent days, I was made to believe that my acne will go away once I become older. However, things got worse over the years. Much later, a few years ago, my routine blood workup detected under active thyroid gland and low vitamin D level. I was started on Levothyroxine and on Vitamin D replacement.

My daily care routine to keep off acne 

And my pimple saga continues

Almost two years have passed since and I am doing fine except for the acne part. I can tell you it’s most annoying to live with something that makes your life less extraordinary. It’s not worth to live with a constant pain of not being able to get rid of an apparently benign medical condition. There must be a cure and I must see the end and I decided to see a dermatologist.

The first visit

The doctor heard me out. He sat through my ramblings, examined my face and asked for a few blood workups and started me on medication. These are new blood workup for me.

LH (Luteinizing hormone), FSH (Follicle stimulating hormone), Prolactin, Testesterone, TSH (Thyroid stimulating hormone)

He also started me on:

Mizoz ER (Minocycline) antibiotic x 1 month

D Acne Foaming Facewash

UV Acne Sunscreen

Deriva BPO Gel

Asked me to stop all kind of cosmetic and market products

Asked me stop all natural products (yogurt, honey, facepacks, eggs, besan etc.)

After 3 weeks of first visit:

I was feeling much better inside and out. The itchiness had reduced, the cystic pimples dried up. A few fresh bumps did show up but those were of harmless kind and subsided soon with Deriva BPO gel. The only disappointing thing - the acne had started to leave dark scars on my face.

On the second visit after 4 weeks

My doctor told me that I look better. My general pathology is reasonably good. Meanwhile I also did ultrasound to rule out PCOS and it was normal too. He then asked me if I am pregnant or planning to get pregnant because he wants to start me on a medicine called Sotret which pregnant women cannot take since there is high risk of serious birth defects. 

Sotret is Isotretinoin molecule prescribed for treating severe nodular acne and is supposed to be very effective with my kind of chronic acne. I was bit apprehensive but then I was willing to go to any extent to get rid off my acne. 

So, on the second visit I was started on:

Sotret 20 mg OD x 1 month

Emolene hydrating cream

So, he started me on Sotret 20 mg once daily and asked to drink profuse water along with it. With all the goodness Sotret comes with some noticeable changes and my side effects got prominent pretty soon. Within 3-4 days my face got noticeably tan, skin dried up, lips, throat and eyes were considerably  dehydrated. This is inspite of applying the moisturizing cream 2 times at least. I also started applying eye lubricant.

After 3 weeks of second visit:

I am on the third week of Sotret now and have not been too much cranky as many on Isotretinoin complain of. However the hyperpigmentation, dry skin and withered look continue to pull me down off and on.

My third visit is pending on the third week of July. Will keep you posted. 

My daily care routine to keep off acne

My whole life has revolved around one single medical condition and if you are curious it is that part of my life that I have been fighting since forever. Yes, this seemingly non serious medical condition, a.k.a acne, can have extraordinary effect on your skin and mind. I was in my pre teens, must be eleven or twelve, when my face saw a tiny breakout on my cheek for the very first time. It started in a benign manner and every other day I would count another one and then another and then another. I tried every single, over the counter medicine. I tried natural therapy and I tried grand mother's age old secrets. But my pimple saga continued.

Later in life, when I started working as a healthcare provider I dragged myself through several examinations like ultrasound, blood work up like thyroid profile, hormonal profiles, Vitamin D, B12 and other ilks. Apart from a high thyroxine and a low vitamin D level (which my doctor said needs minor tweaking) I was cleared of all other medical conditions. So, was it idiopathic? I am still trying to figure out!

More than twenty years and many seasons later, I still continue to have breakouts and have sort of accepted the fact that I will have to live with it forever. So, I try and stick to my own daily care regime. Treating acne is an arduous process and there is no real quick fix. So, continue to have patience.

1)   A clear and clean skin can do wonders. So, no matter how exhausted you are do not go to sleep without cleaning your face. I clean my face after work at home with medicated cleansing lotion . Sometimes when my face seems very dull and dry I use cleansing milk as well. I wash thoroughly with Acne Foaming Face Wash (salicylic + acicylic acid) later on. This medicated foaming face wash is anti bacterial and doesn't dry skin.

2)   Face toner is a must. I have started using toners after shower only recently. I refrigerate my rose toner and it feels great the whole day long. Skin toner has an astringent properties that closes the open pores and help fight bacteria and guards our skin.

3)   Do moisturize daily, sometimes two times even, so what you have oily and acne prone skin.. I use aloe vera gel to hydrate my face. (Hydration is an important part of keeping off breakouts. Drink sufficient amount of water and keep your body hydrated.) There are several good brands selling virgin aloe vera. You can grow it yourself as well. I have just stated growing mine. It grows fast and has an addon therapeutic appeal to the eyes. I use Emolene hydra cream occasionally.

4)   Treat the raw breakouts. I use benzoyl peroxide + adapalene gel on the fresh breakouts. I apply a just a dab on the breakouts and it works wonders. Just for the record, I have had a desperate delirium of importing benzoyl peroxide (Oxy 5) from the US and also had bought 6 packs (it was not even buy one get deal) when I visited the NYC. Deriva BPO gel is as good. I also use sandalwood paste mixed with turmeric powder and apply it on the pimple. It has a drying effect and soaks in the grime and oil in no time.

5)   Another very important thing is to apply UV protection on face, neck and exposed areas liberally. I use D acne SPF 40 +, anti acne, anti grease sunscreen cream.

To sum up, you need to upgrade your daily face care kit with some must haves and I want to pitch in mine. A cleansing lotion, foaming face wash, skin toner, aloe vera gel and a SPF cream. Following a daily care routine certainly helps in maintaining the much needed balance. It also helps in feeling good every day. Do try and keep me updated.

Note: I am also planning to see a doctor later this month for my acne. Will keep you posted with more tips.

Photo: Hedy Lamarr

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And my pimple saga continues

Happiness in a storm

We have spent an inordinate amount of time figuring out the relationship between positive mindfulness  and its impact on our health, and today medical science has proven that positivism influences our brain cells and escalates our health. That explains why some patients with terminal disease live longer than others, or why with some people life seems easier than others. 

This is unarguably also the reason why my opthalmologist tells me to live stress free since negative emotion flares up health conditions. With each bout of stress my eye condition flares up and this leaves me extremely low and to a more stressful existence. Talking of which, now I know how my parents were being able to pull through extraordinary life circumstances inspite of being faced with some handsome health conditions in different phases of their lives. They have been fostering positive emotions all through, in the middle of all bizarre health crises and have had an extraordinary time fighting those.

The impact of positivist on health got reiterated only the other day ,when my boss, a renowned doctor himself, mailed me an article by Jane E Brody. "A Positive Outlook May Be Good for Your Health". The article wonderfully explains what happens to you when you are positive and sums up 8 skills to practice to stay happy and calm when your health is not going good. Quoting from the article:

An important goal of the training is to help people feel happy, calm and satisfied in the midst of a health crisis. Improvements in their health and longevity are a bonus. Each participant is encouraged to learn at least three of the eight skills and practice one or more each day. The eight skills are:

■ Recognize a positive event each day.

■ Savor that event and log it in a journal or tell someone about it.

■ Start a daily gratitude journal.

■ List a personal strength and note how you used it.

■ Set an attainable goal and note your progress.

■ Report a relatively minor stress and list ways to reappraise the event positively.

■ Recognize and practice small acts of kindness daily.

■ Practice mindfulness, focusing on the here and now rather than the past or future.

The beauty of deep work

A note to my children (nephew and nieces)

Because you three are the best and because I love you 'deeply' I would like to share something that I am currently reading. 'Deep Work' is magnificent. When we do deep work we alienate ourselves from the peripherals and endeavour to perform that task alone. This also means that multitasking is largely a myth. Deep work as opposed to multitasking reiterates the fact that we end up performing better and bigger in less time.

So when you are studying, reading, dancing, playing or doing anything - JUST DO IT ALONE. Keep other stuffs at the back seat and do it passionately, deeply, with much love. Refrain yourself from the distractions, from all those pings in your gadgets, from the hangovers, the impending burdens etc.

I am not asking you to stop using your devices. Allot a time for that too, for your internet time only. Do one thing at a time and soon you will realize that the beauty of deep work is in the sense of completion, in the sense of a perfect satiated feeling that would make you so beautiful when you grow up. Deep work is in a way an answer to the much talked about work economy and the search towards inner peace. Trust me in no time you will understand the worth. Ping me then. Much love.

#DeepWork #CalNewportTop of Form

Note to myself on Women's Day

A true woman is liberated. She empowers people she comes across. She is strong and composed; she loves others as much as she loves herself. She knows when to say NO and how. She smiles off the odds and cries in happiness. She is like a ocean - deep, consistent, wobbly at times. She is an endless story.

She makes herself safe on roads at mid night. She helps others do that as well. She stands for herself and others. She knows her mistake and owns up to it.

And of course she is DONE WITH all the talking and she actually DOES. She is REAL. She doesn't walk in man's shoes. She doesn't wait for her rights to be plated; she makes everyday a woman's day. She is she for always and forever.

She is the woman I would love to become..someday..

#WomansDay #IWD #NoteToMyself on #WomansDay

The year that was - A walk through 2016

We had some unpredictable endings this year. With the massive demonetization the whole socio economic and political scenario shuffled to a point where the common people were pushed to the wall. People but had to be a part of this eruption and were extremely devastated and disillusioned in the process. Amidst this, the two things that came into major prominence are cashless and ATM. If this is a part of "achhe din" I do not know, I do not want to know either. All I know at this point in time is that all changes are opposed, confronted, criticised till they are actually accepted and we are going through the initial phase now.

I, myself, was extremely excited about the move so much so that I went on to voice my adherence on several platforms. Little did I know then that this would turn out to be really bizarre. Once again we were shamed by the blatant corruption issues. A group of ingrate opportunists played it really low. My heart broke several times after that and I tried not to hit the social media - Twitter, Facebook, Instagram etc anymore. I am a strong person and my sense of ethics, sense of judgment and values are ingrained in me quite early in life. The offshoots of demonetization hit me badly and I felt very small. All those angry social vents seemed preachy and inane and I really needed the sun. And as I was struggling to come in terms with the most revolutionizing endeavor of the government I realized that it's almost new year.

2016 had some bad things in store for us, my family. When we were planning a fantastic trip to Benaras little did I know that a friend for lifetime was awaiting my return. I was diagnosed with uveitis. This was a shock of a lifetime! Before I could decipher the language of uveitis aka iritis I started having flares of idiopathic uveitis. This continued for the next six months and I had to be on dreadful dose of steroid drops. It felt like grains of sand inside my eyes all the time. The eyes and everything in and around pained and my vision got blurry. Those were the most terrible period of my life when I was made to believe that I would not go blind after all.

Nonetheless I agreed on a trip to the US and as it turned out, I got the US visa (of which I have written in my previous article - The US visa experience). As I was coming in terms with my health condition, the trip to the US was seen materializing. The next few days just swept past, and soon I sat myself to a long flight to the US. I stayed there for nearly a month and shared some wonderful memories with my sister, niece and brother-in-law. We went on drives, experienced the feel of summer workshop (courtesy my niece), explored the plethora of world cuisine, I whetted my culinary skills etc. etc. etc. I was also religiously administering the steroid drops hoping that it would be the last flare of my life. Meanwhile my family in Dubai was settling some life changing decisions. It is hard to let go of two decades of assimilation and decide to ask the children to reclaim the culture and living of which they were never a part of.

All said and done, I am a very positive person and I see silver lining in even bizarre things. I am realistic too. I  believe that all endings flower a new beginning and all the not-so-good things in life pass. "This too shall pass" and soon. Have faith. I wish you all a blessed new year ahead. Inspire and be inspired. Love and lots of love.

Photo credit: theodysseyonline

The US visa experience and how I cracked it

Three months have passed since I am back from the US trip and very often I get flashes from the beautiful stay that was in the US. It was a trip that would be hard to forget for several reasons. These I am going to pen down gradually here. The first part of the US Visit starts with "The ultimate VISA experience". The US VISA - as much as it sounds fascinating the actual process may not be so. But if you are one of the luckier few like me you may crack it just like that.

The ultimate US VISA experience

I did my homework. Yes, quite a bit of researching on the internet and what I realized was that you may manage to get a brownie point if:

You are rooted to your country as in job, property, family. All of these would make you want to return to your country no matter what. 

Apparently I scored a zero and my prospect of the US visit seemed a faraway dream. I am single. I don’t own any property. I am not a professional. All are outright down points towards getting the visa.

I presume, I was snapping at everyone who was already congratulating me on the soon-to-be US visit. I told them that I was not getting the visa. I myself was pretty much convinced of it.

The US Visa procedure has two parts. The Biometrics and the Interview. After filling the form online, I chose the two dates. It’s a simple form and you do not need to know rocket science to do it. I remained honest. Every bit of info I provided was true to the tee. This was what my boss had told me do. By disclosing the truth and the truth only you will most likely to get away with the untoward questioning session during the interviewing process.

The Biometrics

I was called in right on time after an initial screening of my passport and the confirmation of the online application. I had to enter without anything but the passport. They put me through a manual security check, scrutinized nails and palms and sent me to the final counter for the photo click. The lady had great deal of trouble getting my snap. She was finding it difficult to adjust the camera to my height. She finally she could capture my photo. She also recorded my fingers prints and I was done with the Biometrics.

The Interview

There had been a gap of 20 days before I could get to the interview date. I was much before time and it was a real long wait at the entrance. And then my time arrived. I had to go through an exhaustive security check where I had to leave all my stuffs. Yes all my stuffs! I was frisked really bad. It gave me a feeling of being a convict.

In the second phase my passport and the supporting docs were screened after which I was made to wait in the waiting room along with few others. It must have been more than thirty minutes that I was called in for the third phase. There were 4 counters attended by Indian officials. I was guided to one of the four counters. The lady went through the docs. I was carrying a NOC from my boss, sponsorship letter from my father, bank statements, the salary slip etc. The ladies put the rest of the documents (bank statements, my father’s asset details etc.) aside since those, she felt, were not relevant and asked me to wait for the 4^th and the final phase.

After a wait of half an hour I was called for the interview. It was a similar counter with no apparent difference from the previous one. One American lady on the other side of the glass barrier greeter me. Then she had frowns on her face. I assumed that she was eyeing through the application form on the monitor infront of her. I was tense. Then she looked at me and asked me:

What is your salary?

Rs…

What do you do?

I work as the secretary to the director of cardiology at….

Which are the places you have visited?

The UAE

Why UAE?

My sisters live there.

You mentioned that your parents are old. Are you the only caregiver?

Yes

Since you will be away who will look after them?

My aunt will come over from village and it is just as matter of 22 days, I guess...

Do you have children?

No

Then she asked me to place my thumb on the screener in front to me probably to match it with the Biometrics. And then, she looked at me, smiled and uttered the golden words. "Your VISA to the US has been approved. You will be informed about the date of your passport collection soon."

That was all!

Still in disbelief, I thanked her, managed to come out and called my mother. She was overwhelmed and so were the others. I went around with a halo the rest of the day. It was an amazing feeling! The day after I received a text from the US embassy to collect my passport. On proper identity screening, I received the passport. My Visa to the US was imprinted there in golden letters. I was granted the US visa for 10 multiple years. What more could I have asked for!

8 Tips to stay productive in workplace

Jane reaches office just about. The traffic was miserable and it was a long pitiful drive to workplace. Having parked the car, she punches the card and rushes to the desk. Then she gets herself a cup of black coffee like always, sits herself comfortably and gets down checking her inbox. Then one after the other she switches to the personal web pages in several tabs. This has been a routine practice since forever. She is in every possible socializing site - twitter, facebook, Instagram - you just name it, and she has to have logged into each one of them before she gets herself to work.

Even before Jane could sit down to download her work emails, she is occupied. Her brain is scattered and loaded with all things but work. Her productivity at work is indescribably dwarfed by her sloth brain. Besides, her optimum cognitive skills are not explored to the full. No wonder, Jane struggles to catch up and sits on the never ending backlogs slogging in the supposedly productive hours in office. Not surprising that her appraisal showed a down curve and the increment was not at par early this year. She is on a look out elsewhere since. Amidst this Jane found herself very upset little realizing that it is not her supervisors but her erratic work pattern that has been getting on her productivity. Thriving on the alluring toxicity of the junk boxes in work hours, in the work place is making her slog, unproductive and a unsatisfied.

Jane is not alone - this is our story as well. 

So, what is coming between us and our productivity?

1) Obsession with the virtual world

Checking the inboxes and texting every minute, several times a day do little to keep us up to date. On the contrary, we lose our productivity and creativity at work. Switching off personal phones or put them on voice calls helps maneuvering more efficiently.


2) Streamlining the to do list and understanding the priorities

At the end of the day we have only 24 hours of which about 6-7 productive hours. So, we need to prioritize. What should come first and what should be done first, understanding the need of the time and doing things at the right time will make us both productive and happy.

3) Declutter: The 5S of total quality management

Workplaces in Japan are well‐known for their cleanliness and orderliness. The logic behind the 5‐S practice is that organization, neatness, cleanliness, standardization and discipline at the workplace are basic requirements for producing high quality products and services, with little or no waste, while maintaining high levels of productivity. There are five 5S phases are "sort", "straighten", "shine", "standardise", and "sustain". Following these simple 5S we can actually improve our productivity greatly. Also, meeting up small targets, one by one, instead to multitasking helps in completing a task fast and well.

4) Saying no to procrastination

Many of us sideline the major task and hang on to the peripherals. Saving the crux for the last doesn’t always help, especially, when you are multitasking. We should do the main tasks first when our mind is still refreshed. The tertiary would be done no matter what. Procrastination is one deadly sin that keeps us off from being productive.


5) Eating lunch at office

You are so bogged down with job that you even want to work in lunch time. So much so that you are snacking all the time while working and do not quite getting up, stretching back, walking straight , looking up, breathing the fresh air. This doesn’t do any good to the quality of work you are doing. As much as we think that eating lunch at office would extend the working time, it actually eats up the quality time. We slouch, snack often and slog at work stretching one hour to four hours job.


6) Working late at night

Whoever coined the adage, ‘early to bed, early to rise, makes a man healthy, wealthy and wise’, was certainly a wise man. Staying up late at night, working late hours does little to increase our productivity. We need a good sleep after the day’s work. Our biological clock doesn’t understand deadlines.


7) Drinking too much coffee

Caffeine does not give us lasting energy; caffeine that’s loaded with sugar is toxic. The sugar in the coffee is likely to make you hyper, spike your insulin levels, crash, and then get stored as fat. In other words, it’s not really the best thing for boosting productivity. Eat a good fat low carb full breakfast instead to keep your energy up.

8) Stay away from petty office politics

The best way to keep you off from petty politics is to ignore the people who donot matter in workplace. Ignore what others have to say about you. Do not hold grudge and stay congenial. Researches show that happy employees who rise above office politics are more productive and more creative too.



Photo (C) ~ Fastcompany

Why you need to confide in your doctor?

The power of good relationship between a doctor and patient is immense and the impact of this on treatment of diseases is extraordinary. The relationship can fantastically improve the mental health of a patient. A noncongenial relationship may lead to situations where the important health facts are missed making the diagnosis incomplete and misleading. As a patient you have to confide in your doctor, you have to ask him questions, share your problems and also sometimes take call of changing your doctor. It's simple, doable and a two way process. The compatibility factor is very important.

If your doctor shows you the door or cuts you short or is not keen on listening to you it's time you saw another doctor. No one in the clinic will ever going to tell you that your doctor is incompetent so you have to take the call. Researches have proved that the best doctors are not always the best relation makers. They have a signature tuning issue with the patients which could be attributed mostly to the lack of time.

On the flip side, this is true for the doctors as well. There are many instances where the patients visit a doctor just because the doctor is available, stays near his place or because his doctor in on leave. To top it, the trust factor is virtually zero. This is impeccably demoralizing for the doctor and may be considered as one of the many reasons why a doctor refuses a patient.

We cannot deny the fact that inspite of all the bad names that the profession has acquired over the years, the doctors are no better than a trapeze artist, trying to keep himself on the balance all the time.This probably is the reason why the doctors have to conduct series of diagnostics on patients who are supposed to undergo just a cataract operation! The evidence based on the clinical examination is not enough to keep a doctor off a suing. This is appalling but true.

Given such scenario, the relationship between the doctors/ medicos and the patients is of immense significance. It's not just about the doctor and patient but also about a whole league of medicos that constantly strive to strike a humane chord. An agreeable doctor-patient relationship enhances a lot of aspect that is not only medical but societal, economic, political etc.

Confiding in your doctor helps you immensely in getting the best medical help. Your doctor will tell you everything about the line of treatment that he is planning for you. You will be updated about your health issues very precisely. The transparency will help in eradicating many uncalled for hassles.

Once the trust factor is established your doctor will not go overboard with the tests and diagnostics. He will keep you in the frame always before conducting any test. If and when your doctor is convinced that you are not going to sue him he will be able to treat you more freely. Also, less and only justifiable tests will be performed on you resulting in less expense for your pockets.

Nothing like being able to confide in your doctor because he is the one who is supposed to know all about your personal stuffs. Once you know that your doctor is not going to divulge your profile you will find a friend in him. That should be the objective that every doctor and patient must strive for.

Photo credit ~ irishhospital

 

How to prepare yourself before doctor's visit and make most out of it

I have been meeting patients everyday for several years and have noticed that there has been a striking shift in the delineation of the patients. Patients are more involved, interactive and informed than the pre-internet days. Also, as much as we revere the profession of a medical practitioner, the role of a doctor has been most discussed and often criticized.  What a doctor should do and what he should not, how he should and how he should not etc. have put their lives on perpetual edge. We are quick in passing judgments about their societal and tangible roles as in rendering proper, timely and cost effective medical treatment.

However, how many of us are aware about our roles as patients? Are we doing our bits as patients? What are our duties towards a healthy doctor-patient relationship?

This article is research based and I would hope that reading through this will help you understand your role as a patient. Aside this, you will also find this article helpful in organizing your medical data and coping with your medical condition. So, how to make most out of your doctor's visit?

What  you must do

Take the usual dose of medication before seeing your doctor

If the appointment is in the morning time you should not miss any of the morning doses. This, especially, is relevant for the hypertensive patients who are on regular anti hypertensive medication. If he the morning dose of medicine it gets difficult for the doctor to alter and correct the dose of medicines. 

Carry all the medical documents along

You, as a patient should carry his medical file, even the ones that he feels irrelevant. Let the doctors decide on that. This would make the visit so much smooth. The doctor gets to know the history, the medical conditions, the past hospitalizations in less time. Besides, the risk of missing an important information is averted.

Carry the medicines you are currently on

The doctor would most definitely want to know about the medicines his patient is currently on. This also may help him detect the probable side effects that the patient might be having from a medicine. You, as a patient, should keep records of the previous treatment. inform your doctor about drug allergies, supplements you are on, sensitivity issues, past hospitalizations, other illnesses that you are being treated for etc. 

Nothing wrong in being internet savvy but choose your source smartly

With the advent of internet life has been so much easier. From battery to books to medical conditions to their treatment - most of us are now self educated medicos. This may run us into grave things that we may not be able to reverse. Internet is great but we must not feed ourselves on the unauthenticated sources of information. At the end of the day, only a doctor, you heard it right, only a doctor will be able to treat you right - not the internet.

Bring along mags, books, ipods etc.

You should not equate visit to a doctor with visit to a friend's or with visit to the super market. You should come prepared with the probable waiting times. Let's face it - doctors are supposed to run into emergency anytime. 

Consider involving your friend/ spouse/ parent

Come along with someone with whom you are comfortable and may disclose your personal stuffs. Sometimes, patients are unwilling to share medical history with the doctor that may have played an important role in the diagnosis.

Speak up and ask

Feel free to ask questions to your doctor. You should know about your health conditions and what your doctor is planning for you. Ask about the medicines, plan of treatment, diagnosis etc. Also, make sure you can read your doctor's hand writing. Else you can ask for a typed/ legible prescription. 

What you must not do

Know your conditions and health issues. Respecting the value of time you should come prepared with all the questions you want to ask your doctor.  Also, keep in mind that not all doctors want to be asked. So:

D not interrupt your doctor. Value his expertise.
Do not take calls in between. Do not get distracted by your gadgets. Switch off your phone and gadgets before entering doctor's office
Do not digress too much. Come prepared with the questions that you want to ask your doctor. So, be very precise and crisp and choose your questions wisely.
Do not be repetitive. Some doctors do not indulge in too many questions. Keep it short and specific.
Do not pad your queries. Be open and matter of fact.

Do not record the session with prior permission. Do ask for permission. Else, most doctors going to shoo you off.

PS: I work in healthcare facility for more than ten years now. 

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Photo credit ~ AMD

How well you know your heart: A guide to various heart conditions

Today, everyone is familiar with the term ‘heart disease’, but not everyone is conversant with the spectrum of diseases related to the heart. What commonly referred to as heart disease is actually a bouquet of heart conditions with some connections and many differences. Heart ailment is a terrible thing to dwell with. It’s dreadful. As much as it sounds bizarre, it is heart-warming to know that this petite fist size organ can manipulate all rhythms of our lives. As a heart patient, caregiver, conceivable candidate for heart disease, as a healthy person we must initiate to know more about the most beautiful part of our body that works sequentially 365 days, nonstop.

Heart disease talks may get intimidating more so for a non-medic like me. Having said that, I have tried to demystify it, and so this article happened

Angina, atherosclerosis, heart attack

We come across many people who often say that they are having angina. What is this angina? Angina is simply chest discomfort, fullness, irritability that is caused by reduced blood flow in the body. Arteries are channels that supply blood with oxygen in the body. Arteries get clogged and taper due to calcium and fat deposits from bad food and sickly lifestyle. People with unstable angina show signs of discomfort on chest, neck, arms and even stomach and need to get immediate medical help. Since our whole body is like a fish bone array of arteries, they may get clogged elsewhere also. Likewise they are referred to as cerebral (brain), pulmonary (lung), peripheral (limbs), renal (kidney), carotid (neck) etc. These are all cardio vascular events. Heart attack (MI - myocardial infarction) happens when an artery is clogged completely (100% occlusion). Heart attack is a life threatening condition. After heart attack (if not treated immediately) the area gets dead requiring extra effort to keep other areas of the heart healthy.

Arrhythmias

Some people suffer from arrhythmias. Arrhythmia is abnormal irregular heart rhythms caused by erratic electrical system in the heart. Heart may go slow, race, skip etc. They can cause a variety of symptoms like dizziness, fatigue, shortness of breath, blackouts, fainting and palpitations. Arrhythmias may feel like flutters in the heart and is a very disturbing feeling. If left untreated, arrhythmias can be life threatening. There are different kinds of arrhythmias, like, VT, SVT, AF (AFib), tachycardia, bradycardia etc.of which only your cardiologist can guide you with.

Heart valve disease

Heart valves are shafts that control the flow of blood in one direction only. The valves lie at the exit of each heart chamber and maintain one way blood flow without leakage. It is important that I go into little details here. It took me many years to understand how heart valves function but it is not that complex after all.

The heart has four chambers. Right and left atria and right and left ventricles. Blood flows from right and left atria into your ventricles through the tricuspid and mitral valves. When the ventricles are full, the tricuspid and mitral valves shut. This prevents blood from flowing backward into the atria while the ventricles contract. As the ventricles begin to contract, the pulmonic and aortic valves are forced open and blood is pumped out of the ventricles. Blood from the right ventricle passes through the open pulmonic valve into the pulmonary artery, and blood from the left ventricle passes through the aortic valve into the aorta and the rest of the body. This pattern is repeated over and over with each heartbeat, causing blood to flow continuously to the heart, lungs and the body.

Heart valve disease can develop at or before birth (congenital) or can be acquired sometime during one's lifetime.  Children often acquire inflammation of the valve, holes in the heart (ASD, VSA), etc. which sometimes remain undetected until adulthood. Valve disease is mostly caused by untreated rheumatic fevers caused by bacterial infection in childhood. Valve problems are characterized by weakness, extreme lethargy, shortness of breath swelling of ankle, joints, feet. .

Heart failure

Heart failures are extreme conditions when our heart slows down and fails to pump good blood to the whole body. Heart failure is a chronic, progressive condition in which the heart muscle is unable to pump enough blood through to meet the body's needs for blood and oxygen. This can be due to thickening (hypetrophic cardiomyopathy), restricting (restrictive cardiomyopathy), enlarging (dilated cardiomyopathy) of the heart, heart muscles or the heart sac. Heart failure is a serious condition that needs long term treatment and in many cases inspite of optimum medical help patients do not survive.

Heart conditions are triggered by uncontrolled blood pressure, chronic diabetes, kidney disease, high levels of bad cholesterol (low HDL), unhealthy eating habits (binge eating and excess sugar, high carb and less nutrient dense diet), smoking, obesity, sedentary and erratic way of life. Although by modifying these we may achieve a heart safe body, we can never be sure.  

Photo credit ~ irishfoundation

Reward yourself with good shoes

Show me your shoes and I will tell you who you are. Of late I have developed a strange love for shoes. Flip flops, tiptoes, platforms, not so highs - you just name it. I love to reward myself with good shoes. Trust me, it's not just a lavish but a utility you would love to pamper yourself with.

Having shopping for the right kind of shoes, (this keeps changing with seasons and mood), I have realized one thing. Shoes are damn pricy and the ones that keep your eye balls rolling will keep your wallet upside down as well.

The fact that I wear most of them, most of the times in the workplace and that they should be comfortable on feet, I keep a few things on mind while shopping for the ideal ones.

Comfortable on toes and heel

I am lucky that I do not suffer from any physical problem, like heel spur, bunions etc., but for those who do it's advisable to buy shoes with cushioned and roomy bed. Go for the ones that you are comfortable in considering your body weight, work status and nature of work.

Chic and trendy or timeless

I usually go for timeless shoes that do not expire with seasons' fashions. I like flip flops that are always in vogue. However, it's just fine to have a few party pairs like stilettos and high heels in your collection.

Durability

Good shoes are expensive but most are long lasting. I prefer shoes belonging to brands of repute. I use them everyday, all the time, everywhere. I get the best deal from the good brands at the end of the day.

Have less, wear more often and buy often

Shoes tend to lose the sheen and wearibility if kept unused for long. Keep alternating and keep wearing the pairs regularly. Ransack your shoe rack for the ones that are not worn for long. Try to match your dress with them and keep them rolling. After having lost a lot of money, I am wiser now. I have a few pairs of good stuffs now and keep them rolling all through the week. This gives me a chance to go on shopping spree more often as well.

Recycle your shoes

If you think that shoes cannot be recycled, think twice. I give up on my shoes not because they are not wearable any longer but because I don't like them anymore. I give them away to house helps or to the nearest shoe shops.

One last word, shoes make you look and feel beautiful. Reward yourself with them more often.

Picture credit: wedmd

What to ask Your Doctor before Coronary Angiogram?

Coronary angiogram is a complex yet arty procedure where the cardiologist dexterously inserts a narrow tube called catheter through the femoral/ radial artery with plastic introducer sheath. The catheter is guided through the artery into the heart and then dye is injected into the artery. The dye flows through the artery to the heart and stops or goes slow at the clogs in the heart arteries. The percentage of block is asserted by the cardiologists. This whole process is monitored through a highly defined x-ray machine managed by specialized technicians. As much as it sounds easy, coronary angiogram has immense risks attached if not performed by specialized team.

This article will give you insight into the urgency of the procedure or if at all you require it or if you will benefit from it or not

How important or necessary is this test for diagnosis?

Angiography is an important procedure that confirms the ailment. It's just an invasive diagnostic that help the doctors decide on the treatment thereafter. The urgency and the immediate need of the procedure can only be decided by the consultants, who will be knowing the degree and the importance of the procedure.

When is it done?

Doctors recommend angiography when you are symptomatic of pain in your chest, jaw, neck or arm (that can't be explained by other tests), unstable angina, a heart defect you were born with, a heart valve problem that requires surgery.

What to keep in mind before angiogram?

If you:

Are allergic to iodine dye used in the test

Have ever had a serious allergic reaction

Have asthma

Are allergic to any medicines

Have any bleeding problems or are taking blood-thinning medicines

Have a history of kidney problems or chronic diabetes

What will happen during the procedure?

During a coronary angiogram, a type of dye that's visible by X-ray machine is injected into the blood vessels of your heart. The x-ray machine rapidly takes a series of images (angiograms), giving a detailed look at the inside of your blood vessels and the heart.

What are the risks?

Most of the times, major complications are rare. However, potential risks and complications include: heart attack, stroke, injury to the catheterized artery, irregular heart rhythms, allergic reactions to the dye or medications used during the procedure, kidney damage, excessive bleeding, infection, blood clots, radiation exposure from the X-rays

What does it reveal?

An angiogram show doctors what's wrong with your blood vessels. It can:

Show how many of your coronary arteries are blocked or narrowed

Locate the blockages in your blood vessels

Show how much blood flow is blocked through your blood vessels

Check the results of previous coronary bypass surgery or stenting

Check the blood flow through your heart and blood vessels

Check the size and movement of the heart valves

Based on the results, your cardiologist decides on the treatment from which you would be optimally benefited. For instance, that you would benefit from having coronary angioplasty, bypass surgery, valve replacement or just medical management.