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

All for the love of Haikus

I love haikus and I think they are just fantastic. Although I love all kind of poetry forms, but my love for haikus has perked up my life extraordinarily. This amazing rendezvous started nearly ten years back when I was writing prolifically on different forums. As a beginner, I wrote haikus for that was the easiest thing to do when you needed to post an article daily as a paid job. I was writing haikus everyday and was loving it. It was the only thing that I was doing as a routine and loving it.

I love haikus in all forms but the ones that celebrate love liberates me. Haiku has an instant appeal and to start with I was mesmerized by its simplicity. Besides, it was never complicated and I could connect to the fervor instantly. It took me a while though to understand, conceive and learn the art of writing haikus. My passion for haikus soon made me pen down..

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Collection of my haikus

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For people who are not accustomed, what is haiku?

Haiku is a very popular Japanese form of poetry. Previously called hokku, haiku was given its name by the Japanese writer Masaoka Shiki by the end of the 19th century. It conveys a vivid imagery in 17 syllables, essentially dedicated to the fervor of nature with a seasonal theme. Over the years haiku has evolved and the transition has been very smooth just like the poetry form itself. Haiku can be on any theme as long as it is not complicated and designed to a render precise thought. 

"A haiku poem consists of three lines, with the first and last line having 5 moras, and the middle line having 7. A mora is a sound unit, smilar to a syllable. Since the moras do not translate well into English, it has been adapted and syllables are used as moras." 

The most popular Haiku can be represented as follows:

12345

1234567

12345

This one I wrote sometime back -

Tuesday rain haiku 

Tiny drop trickles

Slurs down my earthy brown cheek

Tickles me, I laugh

And this one is my personal favorite - 

You May Now Kiss the Bride haiku 

Color, pomp, prose, fun
Grandeur, giggles, glitters
Hopes sewn in I do

Haikus are very close to my heart. Although I have many haikus to my credit I still find it extremely challenging to be able to conceive one. My haikus are based on various fervor and are palpable. Sometimes they are overly sentimental, sometimes dark and sometimes funny. But all of them have a common thread - the thread of romance that celebrates nature and love.

Haiku is beautiful and each time I read one I love the form more. For me the appeal is not only in the simplicity but in the vividness, in that of the heart warming story telling. Haiku can be best described in the words of Rabindra Nath Tagore. Tagore expressed it all while describing "what is a short story" when he said 'shesh hoyeo hoilo na shesh' - Finished yet not so. I find this just apt for describing a haiku. Haiku ends before it starts and tells us an endless story.

 

Wrath

My thoughts for the people of Nepal who are braving the earthquake

The deadly shudders

Tears, despair, loss of hope

Rains pelt weeping face

The Nepal Earthquake: Loss of humanity, history and more

 

The Nepal Earthquake: Loss of humanity, history and more..

Nepal, 25/04/2015: Earthquake Magnitude 7.9

At about 11-30 am today, Nepal and the Sub-Himalayan belt are hit by a horrific earthquake. An earthquake that most certainly would be considered as one of the century's tragic demolitions of mankind and history. This was also the third and the worst conceivable earthquakes that I have experienced ever.

I was in the office, sat comfortably doing my usual thing when I realized that something not quite right was happening. I felt lightheaded, dizzy and indescribably hollow. Was about to attribute it to my skipping breakfast thing when I noticed that the mirror and the towel in the ring were swaying unusually. It went on for about 10 seconds. I was still confused when I heard someone screaming, 'it's an earthquake, it's an earthquake'. By then everyone had left their desks and started to move out. Though late, my boss and I headed towards the portico with our phones on trying to reach our homes. People were panicked to death. The patients in wheelchairs who came down for investigations could not figure out what was happening. Unnerved and dazed, I realized that our phones were not working.

Everest Climbers Are Killed as Nepal Quake Sets Off Avalanche

Nepal’s Landmarks, Before and After the Earthquake

It was after about half an hour later that our phones started working again. We contacted our homes and were relieved to know that they were all safe. I rang my niece in Sikkim. She was safe too. People who live in high rises were struck terribly. Utterly shocked and distressed, it took them some time to come down. Besides, the towers were wavering - moving forth and moving back. It was horrific. To top that the sky started down pouring. People were distressed, horrified, drenched and were all on road.

Later in the evening, I came back home to a bitter reality. Nepal met with a deadly shudder killing thousands of people and leaving several more on the roads. Makeshifts tarpaulin tents were everywhere to accommodate as many people as possible. People digging rubble to pull out bodies and looking for beating lives. Then the rains started pelting and an avalanche set off in the Himalayas.  It was testing time for Nepal.

It was so unnerving to see Nepal in limbo. I am shattered to see the destruction of several century old revered monuments. The quake has left a dismal remnants of the history. People were still stuck in the rubble and as the army and the people try to rescue them, I, sitting not so far away, pinch myself. It could have been me!

Why the Nepal earthquake did not surprise scientists

Since the last few days my evening strolls were cut short by erratic show of thunderous silver lines in the sky. The lightnings, rumblings and the rains. Then, yesterday, I was watching the horrific pictures of fresh volcanoes in Chile and today this earthquake. Something very serious is going on inside our earth and we have earned this like we do most accidents. The hot lava twirlings the untimely shudders and the break outs deep down the earth - I can only wish that people stay safe and stay together. 

The factual details:

-7.9 magnitude earthquake struck Nepal and areas of India, China on 15.04.2015, Saturday killing nearly 2,000 people in Nepal alone.

-The quake struck at 11:56 a.m. local time (2:11 a.m. ET) and was centered less than 50 miles northwest of Kathmandu. It occurred at a depth of 9.3 miles, which is considered shallow and more damaging than a deeper quake.

-The earthquake triggered a deadly avalanche on Mount Everest killing at least 17 people.

-About 35 aftershocks highest reaching 5.5 magnitude followed.

But what I read in NYtimes is very striking. Kenneth Chang say that this was inevitable. Here's the excerpt from the article published soon after the earthquake.

Ancient Collision Made Nepal Earthquake Inevitable

More than 25 million years ago, India, once a separate island on a quickly sliding piece of the Earth’s crust, crashed into Asia. The two land masses are still colliding, pushed together at a speed of 1.5 to 2 inches a year. The forces have pushed up the highest mountains in the world, in the Himalayas, and have set off devastating earthquakes.

Experts had warned of the danger to the people of Katmandu for decades. The death toll in Nepal on Saturday was practically inevitable given the tectonics, the local geology that made the shaking worse and the lax construction of buildings that could not withstand the shaking.

GeoHazards International, a nonprofit organization in Menlo Park, Calif., that tries to help poorer, more vulnerable regions like Nepal prepare for disasters, had noted that major earthquakes struck that region about every 75 years.

In 1934 — 81 years ago — more than 10,000 people died in a magnitude 8.1 earthquake in eastern Nepal, about six miles south of Mount Everest. A smaller quake in 1988 with a magnitude of 6.8 killed more than 1,000 people.  

Update: 26.04.2015, 12-45 pm 

Similar kind of shudder is felt for about 6-7 seconds. The aftershock was of 6.9 magnitude. This time the epicenter was Kodarib.



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We felt the tremors, the shudders of the earthquake !

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

To vote or not to vote

So, I went voting. It was the Municipal Corporation Election in our city. For those who do not understand what it is, very simply put Municipal Corporation is urban local government that takes care of the basic necessities like the city's healthcare, transport, housing, education and other community services. It is headed by a mayor and represented area wise.

Although we have  majorly three electoral parties viz. CPI(M), Indian National Congress, Trinamool Congress Party and Bhartiya Janta Party, the EVM had a long list of other party representatives which I could neither recognize nor tried to. However, having said that, voting has been made easier recently. NOTA (None of the above) option has been an welcoming move by the Election Commission and this has made more people voting pro.

Politics today is  accentuated with frenzied vehemence that we as children had never witnessed. The pre poll forcefulness was all over the places and we were anticipating a not-so-happy election day. Well, all was not so bleak. Our election day was marked by galore of green, saffron and red. The party people were rendering help all day long. The day was hot, windy and by the time the voting was over, the sun turned liquid.

Later in the day as we got to know about acts of merciless savagery from different parts of the city, I realized that we just have been a fortunate lot. I was lucky - my election day was peaceful and a dignified one too.

Photo (C): MouD

More than two years, four semesters and several coffee cups later...

More than two years, four semesters and a result day later I take this trip down the memory lane. The trip, rather a deliberate one, is an endeavor to unfold the series of sequences in my life for the past two years. After almost ten years of similar work pattern in office, I wanted to take up something different. So MBA it was. My choice of taking up MBA was partially greeted by father and fully by others who matter in my life.

I was dwelling in a comfortable office environment with decent package, post and an ever understanding boss. I was contemplating it too. The decision to pursue MBA came all of a sudden. And amidst that suddenness I stood eligible, completed the process of registration and got myself enrolled in a leading B school. It was a two years course comprising of four semesters. Each semester had five papers, five assignments and a Project in the final semester. As much as the process was simple and methodical,  I was swept by the grandeur of the books, papers, pens, colors, academics. The idea of reliving the school days was just fantastic. 

It was tough though. I pulled through the first semester with extraneous zeal, with fewer timeouts and I  refrained myself from all kinds of internet trails, socializing and pleasures that would make me happy. I was studying all the time that I was at home. That was but a few hours after office and before sleep. That came to only three to four hours of studies every day. Meanwhile, I learned mean, mode, median, central tendency. I learned debit, credit, financial statement, bill of materials. As much as I dreaded the thought, I loved the practice sessions. I scored well in them too.

Semester II got really hard. Given the enormity, I decided to change the study pattern and started looking at it from a different point of view. I took up a subject and disliked it, then I took up another subject not it liking it again I took up another. It was like a vicious circle and soon I came back to the first one. I started studying the subject yet again hoping that it might just work this time around.  I was intimidated by the quantitative techniques. My sister tutored me on Skype for a few days but given the vastness, it seemed just like learning the vernaculars. I was exhausted. The sampling methods, data preparation, Manova, Anova etc. My friend came everyday to help me with the debit-credit but it was not my cup of tea either. I was struggling with every page and every day. I was half-hearted at work and was continuously hit by the idea of not making it.

There must be some truth in the adages and perseverance indeed gets us closer to our goals. Also, it's all about doing thing differently and with lot of conviction too. So, I strategically took up the assignments and as I went along solving them  I was learning too. I looked up for every term new whenever I confronted with one. And I was delighted to realize that the system was working.

By the end of Second semester I was smart. It didn't feel awful after that. I was neither complacent nor insecure. MBA is supposed to be tough and by then I had fallen into the groove of dozens of unusual things. I refrained from everything that felt good. I said NO to me-times except for the pre shower hours on Sundays. I learned to let go of the tempting materiality and learned to be more poised.  Even in the in-between semester periods I tried to stay focused with not so much of aberrations. I carried a long to do list which I gradually checked and by the time the new set of study material arrived I was done with the list. Not only did I manage to create a solitude all around me I started loving it also. Lack of human presence did not bother me anymore and I was continuously trying to sneak in extra time for studying. I was falling asleep too and sooner my sleep pattern changed. I turned into a cat-napper.

The third sem brought in lot of fresh air since I could finally get to study the subjects of my choice. Also, I came in terms with everything bizarre, everything less exciting and everything so unsurprisingly books. All said and done, I was still waiting for the Project Work. The synopsis that I had sent after the second sem was approved in full. I was very excited since I was looking forward to start off with my project. It was on a subject matter that I have been observing very closely for many years. The strategies, methods, hypotheses, sampling, the surveys, questionnaire, test runs etc. - I was living it.  Finally after a series of edits I finished the Project Work. By then, I was truly, madly and deeply in love with it.

The fourth semester had unwanted technical issues. Like the hard copy of my project was sent to a different address and I had to redirect it to the correct one, in one of the papers in the third sem I was incorrectly marked absent and I had to sent series of mails to get it re done, the 4th sem center was far off from my home and I tried my best to change it but in vain, etc. The Project was the most exciting and the most time consuming too. I could concentrate on the academics only after I had completed it.

And finally it was over! It was sudden too. One morning I was simply without books! I had yearned for this moment to arrive when I would divorce myself from anything academics, anything MBA. But it felt like an undefined void!

So, almost four months past my final semester, more than two years of studies, several email trails and countless coffee cups later, I humbly admit that I am figuratively smarter than some people on earth. I am a MBA.

Photo (C) ~ resourcefreak

Why no selfies for me

'One word is too often profaned' and it is untaming, obsessive and addictive. It is the inane act of taking 'selfie'. Selfie is the buzz word that has taken over all other internet jargon in no time making it the most used and the most abused smartphone app.

I find this selfie thing very annoying. I hate people taking selfies all over the places, whenever, wherever and out of no where. They don't stop at it and go on to post it in social media for reasons best known to them. The falsehood that envelops the 'likes' from ghost friends in social media is something that gives us virtual pleasure. We are mystified by the unknownness of the internet little realizing that we are drifted far from what is real, what is beautiful and what is ours. I hate it when five to six and more people take a groupie ( a group selfie) when they can conveniently have a nice photograph done without much ado and very neatly too. People are so much obsessed with themselves being appreciated. (So what it is from some virtual user names - some even with funny alpha numeric prototypes). Every second the internet is congested with few thousands of selfies making it viral with unwanted fragmented data. It scares me to think about it all. Once we post a photo we just have had it! No way we can undo its footprints from the face of internet. As a result, ten years hence we just might have to bite our tongue for some duck face act years back. Who knows we may have to struggle to get weird excuses to convince our kids!

Having said that the usefulness of the art of selfie taking cannot and should not be ignored. Selfies are saviors in times of need. It can reach you to someone you badly need to instantly. Like to your doctor who just wants to see your not so nice face spots or your friend hair stylist who may come up with a brilliant suggestion on a bad hair day or your family geographically far apart. To add to it if you can master the art of taking selfies you can really have some confident photos to archive.

Selfies with celebrities have replaced the good ol' time sake's autographs. I wonder, how do the celebrities go through the ordeal of posing with the fans upclose and personal. I find this bizarre. Selfies, today, are all over the places and people post too many of them too often. Also, the celebrity selfies in the endeavour to reach out to the people are all over the social media making the art very shallow and abysmally misused.

Personally, I do take selfies at times when there is no one to take mine and when I may just need to send one to my family abroad. I think that makes sense since I am not posting them on social media just for the sake of it and waiting every moment to check the number of likes that I derive from it. Instagram, Twitter, Facebook are three top 'most selfie abused' places in the world wide web. The downside of this? Something that we are going to pay the penalty for in near future. The penalty for misusing the most beautiful and useful invention of the century - the internet. And the legacy that we are going to leave for our children would certainly not be a pleasant one. Something to ponder upon.

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