Working with 2023

 The year has gone it was really good,

We were fortunate to receive money and food

We worked hard and even had time to play

Now is the time for thanks to say!

Remember well, as we go off into 2023,

Treat all your patients and charge them a fee

No one should be able to point a finger,

And tell you that your treatment let the illness linger!

No more favours and friend and relative benefits,

Selfish motives should currently be a hit,

Because no one is going to give a second thought to us

Medico legally they're all ready to throw us under a bus!

Do your job, do it well, speak less to the point and be curt,

Don't give extra advice, nor worry about them being hurt;

It will take them less than a second to turn to another

So, why oh why should we be cannon fodder!

Family first, fitness second, health will come, keep work for last

There is no need to get rich and famous fast

When it all ends, it won't matter how much or where

Its only family and friends that will be there!

Take a deep breath!

 You know how, sometimes, you feel the whole world and its mother decides to bear down on your shoulders and you feel like there is this immense pressure put upon you squashing you down, squeezing the very essence of your being?

News flash, a lot of people feel like that a lot of the time. At the very least, most adults would have faced at least a day of intense stress in the past one month alone, and I'm being generous in this estimate. For most people, this is a daily event. For most people, they also deny it wholeheartedly.  Unfortunately, this stress can manifest in many ways. The least expected illnesses and diseases can be brought about by a simple process of pressuring the mind into thinking all is not well.

Just a few examples to get you onto speed about what I mean. Things like a simple recurring headache, nausea, acid reflux, cramping in the stomach and gut, feeling of weakness in the muscles, spasms of the muscles, backaches, low back pain, tingling numbness, feeling of currents shooting along the nerve, dry mouth, dry eyes, foggy mind, etc etc. The list is literally endless. The cumulative effect of all this over time leads to us losing our loved ones all too soon. Might be a little too direct and uncoated with sugar but sadly, true!

At this point, half of you reading this are already wondering about the last time you felt any of this and are silently nodding along or smiling with the realisation that I am right. The other half are already beginning to debunk this and getting ready to quit reading thinking this is just another one of the gyaan sessions that most life coaches, mediation experts, good health practitioners and sundry give. I would ask you to read on.

Whether you believe the above or not, there is a way to deal with it. You don't even have to believe your conditions are caused by stress to deal with them. Just try to do what I am putting forward and see if it works. If it does, I don't care what you call it, just continue doing it. Stay happy in the belief that you are one of those that doesn't take stress or don't get bothered by stress! Just do the things I'm suggesting anyway.

The next time you feel one of the above, here are a list of things you do (there is a caveat at the end so read till the bottom)

• Take a deep breath, hold it in, count to five and let it go as forcefully as you can. Do it only 5 times. 
• Wash your face with ice cold water (as cold as you can get), making sure it gets into your eyes and put a little at the back of your head just where the hairline ends!
• Step away from whatever you were doing just before you decided to do this (get away from the stimulus)
• Put on whatever music you like at a fairly large volume (preferably with headsets on). 2 songs only
• Watch a 3 min slip of any stand up comedian that you think is funny. If you are not into stand up, watch a 3-5 min cartoon clip (older the better)
• Get some chocolate, cheese, ice cream, sweet fruit or nutribar into you. A small piece only, we'll worry about the calories later.
• Find a family member you love and give them a big squeezy hug. Make sure they're not expecting it. Watch their face immediately after doing this
• Go to the window or get out into the fresh air. 120 seconds only. Come back in
• Sit yourself down and breathe again. Only 5 times. 
  
• You are done!

Before you know it, you are ready to tackle the problem that got you into that frown before all this was done. You will suddenly see a path or a solution. In case you don't, at least it won't be bothering you as much and you can then work it out.

The caveat -  to do all this and to make it work, I don't even want to you think about it. Yes, most people, including myself, would go into this starting with this crap isn't going to do it, its just not going to work. Humour me, though! Go through all the steps and only once you've done it all, come back to me and tell me that it didn't work. I'm waiting for your responses below!!

Have a holiday the right way

It's the holiday season and everyone is making plans on where to go and what to do. Some have already left, some will leave soon.

What is your ideal holiday like? What should it be like? Do you think you're doing it the right way?

This is a complete personal account on what I would like a holiday to be. Considering I have Toofan and Bijlee, my holiday wishlist is skewed towards holidaying with children.

The planning phase.

I completely love doing this. I can't seem to holiday without it. Also, I seem to plan way too early but it's therapeutic for me to have all the information I need before confirming anything.

I must know where to go, what is there to do, what I am going to do when I get there and what I am definitely going to avoid. I need to know the best options to get there and back. Admittedly, even after planning in advance, I rarely book at the cheapest price. This is probably because I take too long to finalise and am always hopeful for a better deal. I do get good deals most of the time though.

The build up phase.

I love getting the people who are due to travel with me involved in the travel plans. I will show them pics, discuss the good things that are there, play down expectations where required and basically force them into knowing what's in store. I get the kids excited about things they can do there, what they can experience and the buffet table which seems to have become an important part of their holiday breakfasts for some reason. If their friends are joining in, I talk to them about the games they can play, what they can carry to entertain themselves and how late they can sleep.

The packing phase.

This is completely left to the wife and I give her full credit for this. The only thing I do in this phase is make a list.

The day of travel.

Always chaos. Yelling. Get ready, eat breakfast, we'll miss the flight for sure! You can't wear this, it's green and your t-shirt is blue! Wash your face, you've got food all over your chin. Oh no, I've forgotten my glasses. Did you book a cab yet? Why isn't it here? 2 more minutes!!!

Once we've loaded the bags and are sitting in the car, however, everything changes. There is a sudden calm that overtakes us all. It's as if we've finally managed to escape a prison that was holding us against our will. Inadvertent smiles crop up. Goofiness takes over. Everyone is happy. We eat, drink and take trolley rides at the airport until it's time for the security check. The kids are most excited to be screened. They have now been given the responsibility to hold on to their own boarding passes and carry on bags with their art and games. Getting on the flight is great when there is an aerobridge, not so much when they have to take the bus.

On the flight, it's a fight for the window seat or a quarrel to sit with their friends. Out come the colouring books, the playing cards, the reading books and we are at peace till it is time to feed them. This is really messy on the flight and we need to come up with a way to feed kids without dropping things on their clothes.

We're there.

Land at the destination and this is where the fun is supposed to begin. I have a few issues at this stage. I hate my phone and would love for it to be switched off or unreachable. Not so much with other travellers. I don't get how you go for a holiday and then stay close to everything you are getting away from by being on the phone that links you right back. 

I love to get out and explore the place on my feet. I like walking about the local markets and getting a feel of the place. Kids sometimes make this difficult but encourage them from the start and perhaps they will develop the habit. I eat local. Sure, there might be a chance of an infection but that is part of the experience.

I don't believe in the dictum that you must do and see everything the place has to offer. It is a holiday remember. Just relax, take it slow, ease into it and do what you feel like doing. If you don't like sightseeing, forget about it. Take a good book and read. If not, spend a few hours in the pool. If that's not your thing, walk around and do some shopping. Don't break your day trying to reach 5 spots in 24 hours and then just see them for 10 minutes.

I like doing nothing on my holiday. I could sit on a lounge chair and stare into nothingness. I don't need music, I don't need entertainment for me to enjoy my time off because it is my time off. A place where I can do nothing! I can hibernate and am proud of it. A lot of people get upset with me for wanted to do nothing and not participate, but it's ok. I get it. Some people need to be busy to enjoy themselves.

What is your ideal way to holiday? Let me know in the comments below.

Voldemortish experience?

 

Assuming everyone who can read has read Harry Potter, I am relating this past week's experience to he who must not be named! We had a patient who underwent a SILS Laparoscopic Sleeve Gastrectomy last week. The surgery went off well and the patient tolerated the anaesthesia and post op pain quite admirably. The visit in the evening led to this post.

 I went to see her to check that everything was well. She was made to go to the toilet, sit up and even walked a bit. She had some amount of pain which was understandable considering her surgery was performed only hours earlier. She also had a very dry mouth, again obvious, since she was still nil orally post op. She was permitted to gargle and moisten her lips.

 I was waiting outside whilst she was doing this and suddenly her siblings comes running up to me and exclaims, "There's something wierd coming out of her mouth, it looks like a snake or something." Not one to miss out on an opportunity to see something this dramatic, I went on inside, not alarmed but mildly curious.

The patient's face was a picture of perplexity as she proceeded to stare at me and tell me that something funny was coming out of her and were we sure the surgery went of well! I asked her to open her mouth.

Sure enough, looking me straight in the face, swollen to a certain extent, her mouth opening in a way that made it seem to be projecting outwards, hence resembling the dreaded 'nagina'  was what she perceived to be the snake of her insides....

Her Uvula!

P.S. At least it didn't look like this!

Pyrexia of Unknown Origin (P.U.O.)

A fancy way for Doctor's to say they don't know what is causing the fever is Pyrexia of Unknown Origin or P.U.O. When we say it to our patients, it makes us feel good about ourselves, in the sense that we have at the least given them something and proved that we are on the job. In reality, we know just about as much as the patient's relative at that point of time. The relative's guess will probably come true in the end. The only difference being that we will get the answer at the end of the day and the relative will speculate.

I, unfortunately, had the experience of being both the doctor and the patient in terms of P.U.O.

Now, you must understand that it takes a hell of a lot of guts for a doctor to say he doesn't know what is wrong with you or what is causing the fever and the reason for that is simple. Our psyche in India is such that if a Doctor says he doesn't know what is going on, we head off for 2nd and 3rd opinions and when that doesn't satisfy us, we change tracks completely and go to the homeopaths and ayurveds! I have nothing against alternative medicine other than the fact that it is not an exact science in the sense that most of it relies on general build up of immunity and helping the body battle the problem on its own. While this might sound like a good thing, in most cases it is not. There is usually a particular cause for a particular problem, even if it is labelled as P.U.O. initially, and the doctor will find that cause and treat it specifically leading to resolution of symptoms and signs.

Back to the problem at hand. While being the doctor for a P.U.O. patient, I was at the stage where I was to say that I don't know what is cauing the fever. I said it as if it was the most pausible explanation in the world and it should satisfy the patient. For the initial few days it does. Then its upto the doctor to realise that we need to order a few tests to find out exactly what the unknown origin is. We did that. Initial tests were the usual blood counts and liver profiles followed by a blood culture which finally gave us the answer. Typhoid, enteric fever, typhus, salmonella whatever you want to call it.

Soon after that, I had the fortune of being the victim of P.U.O. I say fortune because that would be the only way I would realise the meaning of the sentence given by docs to the patients. Its pyrexia of unknown origin I was told. Being a doctor it didn't make sense to me. I wasn't ready to accept it. What do you mean unknown origin? There has to be a cause. My wife was even more vociferous! Do some tests, find something. There has to be a cause. We did the blood tests, we did ct scans (I was coughing violently), we did an ultrasound (abscess) we did everything and came up with the answer.

The point I'm trying to make here is this - If we as doctor's are sure we are going to get to the answer in the end, why must we give some bullcrack about fancy latin sounding Pyrexia of Unknown Origin to patients when we wouldn't like to hear it oursleves. Secondly, why must we as patients not have enough faith in a doctor to take his time and figure out what is wrong, instead of houding him every hour with temperature updates and the ever lasting question...what is it? what is it?

If our forefathers were to be asked, they would blame it on technology and stress and hectic lifestyles. I think they would be correct. We are in an age of instant updates, live chats, google wave, skype and we want instant answers and instant solutions. This is the problem, this should be the solution and I should be up and about tomorrow. Sometimes, thats just not how it works.

P.U.O. is a way of our bodies telling us to slow down and take time off.