Day 26 - Zumba

Video screenshot from Zumba

I haven't gone for it, but I know a few friends who signed up for Zumba classes. They say it's real fun.

Traditional exercises or dance forms can be too formal. Usually, they are bound by a strict pattern of movements, which sort of makes them too regimented.

(Some of the well-known Indian dance forms: Bharatanatyam, Kathakali, Kathak, Kuchipudi, Manipuri, Odissi etc.)

Zumba adds a liberal dose of entertainment to dance and exercise. There is no water-tight regimen and the routines are flexible, customisable to individual needs, and therefore enjoyable, making it very popular.

Zumba is a trademarked fitness programme that originated in southwest Columbia in the 1990s. It was created by dancer and choreographer Beto Perez, by combining elements from four Latin American dance rhythms: salsa, reggaeton, merengue, and cumbia.

In 2001, Zumba Fitness, LLC, was founded; and in 2011 it arrived in India, one of the over 180 countries where it's now taught and practised.

There is music and a lot of high-impact body movements, including jumping and bouncing. If one is keen on moving into advanced forms, it's better to get prior medical advice.

Like any exercise, Zumba is undoubtedly good for health. It burns calories, loosens joints and muscles, and keeps one agile.

Also, like any exercise, overdoing it won't do any good.

Sources:

Zumba, Mint; WebMD, Wikipedia

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This post is part of the blogging challenge in April every year, wherein bloggers put up one post a day, from A to Z, every day except Sundays. 

The series concludes with this post.

I'm participating in #BlogchatterA2Z. I am also on A2Z April Challenge.

Naomi Osaka's exit and mental health

This is a long post. If you are familiar with the issue of top-ranking tennis star Naomi Osaka pulling out of the French Open this week citing mental health issues, you may skip the first part and scroll down.

Source: Yahoo Sport

Naomi Osaka is a 23-year-old Japanese tennis player. Her first big win came when she was 16 -- when she beat Samantha Stosur, a former US Open champion, in the Stanford Classic in 2014. 

She burst into the limelight less than three years ago, with a sensational victory over Serena Williams in the 2018 US Open. (I blogged about that match that became controversial for other reasons.)

Ever since that she has been doing extremely well in the game and is now among the top-ranked players in the world.

On May 27, in the runup to the ongoing French Open, she said she would not be taking questions from the media after her matches. 

That's one of the contractual obligations players sign into.

❤️ pic.twitter.com/EegFSKnoie

— NaomiOsaka大坂なおみ (@naomiosaka) May 26, 2021

Her reason: Many of the reporters are insensitive. When a player has a lost a match they keep asking questions about that match which is akin to being kicked when one has fallen down. 

In a nutshell, she wasn't in a frame of mind to talk to the media.

Her decision was seen more like a refusal to play by the rules and a move to impose her personal views on the system.

On the opening day of the French Open on Sunday, May 30, Osaka got off to a winning start defeating unseeded Patricia Maria Tig of Romania, who has WTA singles ranking of 56, in straight sets: 6-4, 7-6.

But, Osaka boycotted the obligatory post-match media conference. She was fined $15,000 and was threatened with expulsion from the tournament and other Grand Slam matches if she continued to boycott the media interactions.

pic.twitter.com/LN2ANnoAYD

— NaomiOsaka大坂なおみ (@naomiosaka) May 31, 2021

The very next day, she made the disclosure -- which stunned the tennis world -- that she was pulling out the French Open. She prefaced it with references to how she has been suffering from depression for the last three years.

WHAT WE KNOW

Naomi Osaka is known to be introverted, and nervous about facing crowds. 

During the 2018 US Open, which she won when she was just 20, she was loudly booed by the crowd, forcing her to tears.

That year she spoke about depression. "I am feeling depressed. I don't know why."

The next year, she said the media's focus on her and their questions were her biggest problems.

Every highly performing player -- who willy-nilly gets a celebrity status -- is under intense media glare. That's not easy to handle. 

The pressure to perform and win every match, especially when one is at the pinnacle, can be excruciating.

Players, especially as they climb up the ladder, have a battery of advisors and counsellors to guide and help them.

Big tennis organisations have their own facilities to address players mental issues.

It's the job of the media to ask questions, even if uncomfortable. One can request them to be sensitive and phrase them more appropriately. But it wouldn't be right to tell them not to ask questions.

Having said that, it's true media can be very insensitive. We have seen so many examples of how celebrities have been tormented by paparazzi.   

WHAT WE DON'T KNOW

Though Osaka has spoken about her mental pressures, it's not known if she had officially communicated it to the organisers. 

It's also not known if tennis organisations had taken note of her public statements and reached out to her with assistance.

Also, one doesn't know if the specific issue of "questioning by media" has been raised with the media themselves and organisations and discussed. 

WHEN IS FEELING LOW ACTUALLY DEPRESSION

One doesn't know. That's the whole problem.

There is no point in saying, why Osaka didn't talk about it earlier? We didn't know. That's true. But that's not her fault.

I don't think there is any person who hasn't felt low, down in the dumps, who has struggled to get up and get on with one's life ... 

When is that really a problem?

I have read articles, books and spoken to people who handle mental health issues. This is what I have understood.

Depression is an emotional issue. It's not a physical issue. Others can't see it. Others can't feel it.

The feeling of depression -- which is very common -- normally doesn't last too long. We are able to distract ourselves soon and carry on with our normal routine.

A rule of thumb is that if something unusual is so persistent as to disrupt the normal routine consistently, then it's an issue that needs attention.

That rule applies to the feeling of not being emotionally or mentally well. We don't really know, probably not even Osaka, when the issue has begun to affect her in a detrimental manner. 

OSAKA NEEDS SUPPORT

A mental scar is not like a physical scar. Unfortunately.

Players, when physically injured, pull out of matches. Just yesterday another top-ranking player Australia's Ashley Barti pulled out of the tournament because of a physical injury.

So in the same vein, if they aren't mentally well, or depressed, is it okay for them to pull out of matches or not fulfil contractual obligations?

Are sports tournaments more about matches or about talking to the media?

Is the ability to handle the media also a part of the celebrity package?

Surely there are issues, and something seems to be broken.

It's quite possible that so many players have felt like Osaka has, but they, for whatever reasons, never took a tough stand like she did. 

It's unfortunate that her feelings couldn't be addressed earlier in a more conciliatory manner.

WAITING FOR OSAKA TO BE BACK

It's never too late. She has expressed willingness to talk over the issues and sort things out.

Not just tennis, but other sports federations too must look at these contractual obligations and see if they are all fair to players, especially if there are aspects that are tied to mental health.

What matters most is on-court performance.

Noami Osaka is a gifted player. 

Tennis needs her. 

I hope she will be back on the courts soon. 

On the green lawns of Wimbledon.

Here's wishing her well.

A for Aerobics - My favourite things to counter COVID-19 stress

(This post is part of the A to Z Challenge. I am writing this month on activities that keep me refreshed during these depressing days. It's Day 1 today.)

I was around 14 years then. While I was walking along with my father in the residential school campus, I met the school headmaster on the way. During our conversation, he looked at me and said, "Why don't you go for a run every day. Do some exercise, it's good for your body and health."

Soon my father began to gently prod me to go for a run in the morning. Initially, I was reluctant. Soon, a run for about 30 minutes became a habit. I was also a part of the school athletics team, initially for short-distance races like 100 meters, and later for long-distance ones like 2,000 meters and 5,000 meters. Once a month, I also went on a cross-country run, which is about 8 km.

During these days, it's a bit frustrating to realise that I can no longer do that sort of running, now that I am 55. But I do long walks and short-distance jogging, and follow that up with some stretching exercises and deep breathing.

Health experts say aerobics -- a term that stands for exercises that involve the active movement of our body along with deep breathing -- improves the blood circulation and generally keeps us healthy. These exercises also have a positive impact on our emotional well-being: it's refreshing.

I have realised that what works best is not short bursts of long hours of strenuous workouts, but consistently exercising, every day, even if it's short duration. And many exercises can be incorporated into our daily routine. Like climbing stairs instead of taking the elevator, or washing some clothes or vessels physically instead of putting them in the machine, or rearranging the study table or wardrobe, sweeping the floor and mopping it.

These are days when we need to take care of our physical as well as mental health.

Inspiring story of Minal Dakhave Bhosale

We have to appreciate the highly proactive efforts being taken by the Indian and State governments, in the global fight against COVID-19. Something which I don't see acknowledged well enough either in India or abroad.

For example, all flight passengers from abroad are being subjected to thermal screening at the airport right from mid-January, even before the first case was identified in India, on January 30.

Teams of government officials are tirelessly working to trace the contacts of suspected patients, get them to self-quarantine, as well as make follow-up enquiries about their well-being.

NEED FOR TESTING KITS

However, one of the key elements of the battle is how well we are able to test people. And, India doesn't have enough testing kits.

In the last few days, we have very good news on this front -- a company in the west Indian city of Pune, called Mylab Discovery, has developed a kit, Patho Detect, that is not only cheaper but can also test samples faster.

The Mylab kit costs Rs 1,200 while the imported one costs Rs 4,500. It can provide the results in two and a half hours, while an imported one takes six to seven hours, says this BBC report.

THE HEROINE

The leader of the team that worked on the kit is virologist Minal Dakhave Bhosale, Mylab's research and development chief.

What makes her a heroine is not just that her team was able to come up with an indigenous testing kit but the fact that she was in the final stages of a complicated pregnancy.

In spite of her personal difficulties, she took the scientific challenge head-on and submitted the kit to the National Institute of Virology on March 18. The next day she gave birth to a baby girl.

The company, the report says, can supply up to 100,000 testing kits a week and can produce up to 200,000, if needed.

What an inspiring story this is! Hearty felicitations to Ms Minal -- not just a role model for all of us, but also a beacon of hope in these troubled times.

(This blog post is part of the monthly 'We Are The World Blogfest' that celebrates positive news)

Janata Curfew: India's experiment with total national lockdown

A street in Bhopal, India.
Image credit: Wikipedia

India is quiet like never before.

I woke up this morning not to the sound of vehicles, but to the sound of the chirp of birds.

I have never before heard the rustling of leaves during the day hours when the predominant sound is usually of passing vehicles.

Today the entire nation -- a population of 1.33 billion -- is staying indoors between 7 am and 9 pm. No public transport. No passenger trains. Only trains that have begun the journey before 7 am are running. No buses. No metro. All businesses shut. It's a total lockdown. Only medical services, online delivery services and media are working.

This follows an appeal by Prime Minister Narendra Modi in his address to the nation on March 20, to observe a Janata Curfew or People's Curfew - of the people, by the people, for the people - voluntarily stay indoors between 7 am and 9 pm. He said we have to do it because the crisis we are facing is a very unique one, and we have very difficult days ahead, for which we need to prepare ourselves.

THE FIVE-MINUTE JINGLE OR CLAP AT 5 PM  

The Prime Minister also exhorted everyone to come to their doorstep or to their balconies and clap or ring a bell or tap a steel utensil for five minutes in honour of every health and medical professional who is struggling out there taking care of the people who are ill.

Accordingly, in our apartment complex, many residents joined the rest of the nation, came out on to their balconies, and clapped.

HARD DAYS AHEAD

When the Prime Minister announced just a day's shutdown, the immediate thought that came to everyone's mind was how will a single day's lockdown help in any way. But he had prefaced it saying this lockdown today is to prepare ourselves for the hard days ahead.

That's what is happening now. A number of places in the country, including big cities like Bengaluru, Delhi and Mumbai, have now declared complete shutdown till March 31. Indian Railways today announced that no passenger train will run till 31st. Buses and metro have drastically curtailed their services.

I don't think we will return to our normal routine any time in the near future.

Take adequate care of yourself. Be safe. These are very uncertain times.

The unsung heros fighting coronavirus

It's now nearly three months since coronavirus began wreaking havoc around the world. Over a hundred thousand are now ill and more than six thousand have died because of COVID-19. The numbers are constantly rising.

It all started in Huanan Seafood Market, a wet market in the city of Wuhan in China in the last week of December. The virus spread rapidly from there within China and later outside. The fact that it was the Chinese New Year holiday season only made matters worse since many people were travelling. 

The symptoms are the all too familiar runny nose, cold, cough and fever. But two factors have made this a bit scary and kept it on the headlines around the world. One, the virus is new, and two, it has spread around the world like never before. 

TRACKING THE SPREAD

Though it started from a congested and arguably unhygienic wet market, as the disease spread to different nations, it became associated with people who were only rich enough to fly from one nation another. Top-level artistes, sportspersons, and people in high positions of power were infected. 

It has now moved to the secondary level of infection or local transmission stage, wherein people who haven't travelled anywhere are getting infected since they had come in contact with someone who carried the virus or they picked up the virus from some surface.

GUARDIANS WHO ARE ENSURING OUR SAFETY

The world is trying to contain the spread of the virus by different means. Lockdown of a city and 'social distancing' by people have now become the norm everywhere. 

While a good majority us are playing it safe by staying indoors, keeping track of news in the comforts of our homes, checking our social media feeds, forwarding messages to all and sundry on how to take care, there is a group of people who are taking all the risk only to ensure that the rest of world is safe. 

That is the community of healthcare workers, comprising doctors, nurses, paramedical personnel, healthcare officials, and a huge staff. 

They don't play it safe and keep themselves away from the infected and the sick. They have to be in the midst of the very people who are ill and who need assistance. They have to tend the elderly who are at a high risk of succumbing to the disease. 

COMMENDABLE JOB BY INDIA

India was one of the first countries to begin screening of incoming passengers at airports. It's being done at all international airports in the country. Yesterday, Kerala (which has a high number of positive cases) decided to screen even bus and train passengers coming into the state. 

I am happy that in India, everyone who is fighting this war is doing an admirable job. There are so many first-person accounts of people who have witnessed high levels of efficiency by people are engaged in combating the pandemic.

They are not just reacting to a situation but proactively working to ensure that people who might be carrying the virus are safely isolated so that they don't unwittingly spread the virus to other people. 

There are heartwarming stories of how airport/ airline officials and health workers are diligently tracking passengers who might have flown in an aircraft taken by a person who later tested positive. I also heard stories of how people have voluntarily isolated themselves even though they didn't show any symptoms of the disease. The social responsibility and dedication that these people have shown are admirable.

Several scientists and doctors are saying that the virus is not going to be exterminated from the face of the earth anytime soon, and people will continue to be at risk. But this highly praiseworthy proactive method of fighting the challenge will definitely mean the number of people who might get infected could be kept to a minimum saving hundreds of lives in India and the world at large.

Coronavirus case in Bengaluru

There seems to be only one topic of conversation - coronavirus and COVID-19, the disease it causes. It all started in a city in China called Wuhan, in late December, and now it has spread to over 1 million people in a good number of countries around the world.

India's first patient was in my home state of Kerala - a student of Wuhan University tested positive on Jan 30. Since then many states of India have been reporting cases, most of them are returnees from China or Italy.

Yesterday, the city I live in currently, Bengaluru, reported its first patient. A computer engineer who returned from the United States on March 1. There are now four patients in the state of Karnataka, of which Bengaluru is the capital. More and more cities are reporting positive cases, and the total must now be around 50 in India. There are no deaths.

NO PANIC OR SCRAMBLE

I have been reading news reports from many countries regarding panic buying of essential daily requirements, fearing a shutdown. Nothing of that sort here.

The only time there is shutdown in India is when there is widespread violence, because of any social or economic unrest. That's when the government imposes curfew, and it's for at the most three or four days.

There are cases in India when people do indulge in panic buying. That's when there is an impending shortage of essential farm commodities, mainly vegetables or grains.

Here as of now, there is no panic, though everyone is taking precautionary steps. Schools have declared early summer vacation. Many public gatherings have been postponed or cancelled.

MISINFORMATION AND FALSEHOODS

Social media is flooded with information regarding medicines that can either protect people from the disease or cure them of it. I have been debunking these claims on some of my WhatsApp groups.

Such messages are dangerous because some people might actually think there are medicines that protect them, and won't take the required preventive steps, endangering their lives and that of others too. Such messages are best not passed around.

I have also been advising my friends and relatives not to believe anything unless it comes from a recognised medical authority or a government institution.

Is there a cure for coronavirus, the new threat to human life?

It is truly worrying if something as common as cold or cough could ultimately lead to death. That's what a new strain of the coronavirus, called novel coronavirus, or nCoV, is doing to humans. The virus first surfaced in a Chinese city called Wuhan in December 31, 2019. Ever since then the virus has spread around China and outside China, as infected people travelled from one place to another and infecting other people.

Other strains of the virus are responsible for diseases like Middle East Respiratory Syndrome (MERS-CoV) and Severe Acute Respiratory Syndrome (SARS-CoV), besides the more common respiratory tract infections like cold and cough.

What is a coronavirus?
It is a family of different types of viruses. There are four types of them: alpha, beta, gamma and delta. Alpha and beta infect only mammals, like bats, pigs, cats, and humans. Gamma infects birds especially poultry, while the delta variety infects both birds and mammals. The first type of coronavirus was discovered in 1960s, and since then we knew six of them. The type that has been discovered in Wuhan now is the seventh one.

Why is it called coronavirus?
It is called so because the virus has crown-like spikes that also look like the corona (or the outer surface) of the sun.

Coronavirus attacks which part of human body?
Coronavirus affects the respiratory system.

What are the symptoms of coronavirus?
Common cold, running nose, difficulty to breath, fever.

Any cure for coronavirus?
So far none. There are no medicines or vaccines. Patients are treated for the symptoms they show.

Does garlic kill or reduce the effect of coronavirus?
Can coronavirus be cured with taking boiled garlic water?
There is no scientific proof yet of garlic either killing the new strain of the coronavirus or reducing its effect. But it is a fact that garlic does have many good health benefits, like antioxidant properties, improving blood circulation, and reducing levels of cholesterol. This strain of the virus itself is new. It will take time for researchers to find a cure or a vaccine. There might be anecdotal evidences of patients showing improvement in their condition after taking garlic, or something similar food that has health benefits. But that doesn't qualify as a cure or a medicine.

What kind of indigenous medicine is suitable for coronavirus eradication?
As of now, there is no medicine -- indigenous or any other type -- for coronavirus. Patients are being treated for the symptoms they show.

Can coronavirus be deadly in Indian climatic conditions?

There is nothing conclusive so far to show that people in a particular geographical region is more or less prone to contracting the coronavirus. The 99% of the cases is in China. The rest 1% is spread across all the continents, except Africa.

What precautions one must take?

Wherever we are, we must make sure that we maintain good personal hygiene, keep away from people who have cold, cough or fever; and avoid being in crowded places and travelling in crowded public transport.

Is it safe to travel to Bali from India now due to coronavirus outbreak?

There is no harm in travelling to Bali or anywhere, from India or from anywhere. To say "don't travel", is being alarmist, and it's not the right approach. What is important is to take adequate precautions. (See the answer above.)

Will we get coronavirus if we eat fish or other non-vegetarian food?

Humans first contracted coronavirus from animals in China. But it's safe to eat non-vegetarian food. Only ensure it is properly cooked.

Is it safe to drink cow's milk safe? Will we get coronavirus?

It's safe to drink cow's milk. But ensure it's properly boiled.

What is the incubation period for the coronavirus?
Incubation period is the time taken for symptoms of a disease to surface after the person has been exposed to a virus or bacteria. It's currently 2 to 10 days. However, it's advisable to be under observation for at least two weeks.

Will I be quarantined at airport if I fly with cough, cold and fever?
Very difficult to say. But there is a high possibility that you might be quarantined if you have been to China or you have been around with people who were China.

How many days a person survive after effected from coronavirus?
It varies depending on the immunity levels and general health of the individual.

Sources
WHO - Health topics / Coronavirus
WHO - Q & A on Coronavirus
CDC, US - Types of coronaviruses
WHO - Situation Report
EU - Geographic distribution of coronavirus

Should we take vitamin supplements?

Photo credit: Medical News Today

During conversations with family members and friends, whenever the topic of vitamins comes in, invariably the issue of supplements also crops up. There is always one group which says that there is no harm in having supplements, and there is the other group which argues that there is no need to.

WHAT ARE VITAMINS

Vitamins are needed for metabolism (the process in our body that involves breakdown of food and absorption of nutrients for our growth and energy).

Our body does not produce it (unlike dogs that can synthesize enough vitamin C). So we need to get it from food or from vitamin tablets.

If our body doesn't have enough amount of vitamins it can result in medical conditions.

TYPES OF VITAMINS

There are 13 vitamins, each needed in different amounts for different reasons.

Some vitamins dissolve in water, some in fat.

Water-soluble ones are: all B vitamins and vitamin C.

Fat-soluble ones are: A, D, E and K.

Fat-soluble vitamins can stay in the body: they get stored in the fatty tissues for use later.

Water-soluble vitamins don't stay in the body: they go out via urine.

VITAMINS IN FOOD

Vegetables and meat have different vitamins in different quantities. So, if we have a well-balanced, varied diet we will get all the required vitamins in the required quantites.

Usually we take it for granted that the food we eat has enough vitamins, and there is nothing to worry. Only when some medical condition surfaces, our physician would say that there are symptoms of deficiency.

Vitamins are sensitive to heat and water. Cooking reduces the amount of vitamins. Water-soluble ones get lost in water, and fat-soluble ones in oil.

VITAMIN SUPPLEMENTS

We can get our vitamins from syrups and tablets. We need to take them when we have a medical deficiency of vitamins or in cases like pregnancy when our body does need enhanced levels of vitamins. Doctors will recommend the dosage.

DO WE GET ENOUGH FROM FOOD?

Anything cooked in high temperature or for too long will have less vitamins.

It is lost in water and oil. One way to salvage a bit of it is to consume the water that has been used for cooking. That is why some people suggest to cook in less water and not to drain away the water after cooking.

Cooking in microwave might be better than boiling from the vitamin standpoint.

Raw vegetables are good, but run the risk of presence of pollutants and lack of hygiene.

SHOULD WE EAT SUPPLEMENTS?

Supplements are not substitutes for the vitamins that we get through food.

 They can just make up any shortfall if any. So, our primary source of vitamins has to be food. But since while cooking lot of vitamins get lost, there is a case for having supplements.

Without any lab tests or visible symptoms one can't conclude that there is a deficiency and therefore a need for supplements.

Excess of fat-soluble vitamins can turn toxic, and therefore harmful, since they get stored in the body.

We tend to fall short of water-soluble vitamins since they don't stay in the body. Also, vitamins like C easily get lost while cooking. So, if at all one is looking at supplements, then it's water solubles ones that need replenishing.

All said and done, vitamin supplements are not a guarantor of good health. They are not magic pills.

HOW MUCH VITAMINS WE NEED

We need vitamins in small quantities. But we need them always. This table in the WebMD website lists out the required and maximum dosage for vitamins and minerals.

It would advisable to consult a doctor on how much of supplement we should take and in what frequency.

MY TAKE

As advised by my physician, I do have vitamin and mineral supplements, of low dosage, at wide intervals, just to make up for any possible deficiency.

REFERENCES

Vitamins: What are they and what do they do?

Nutritional Effects of Food Processing

Cooking and Vitamin and Mineral Loss

Studies Show Little Benefit in Supplements

Which Supplements, if Any, May Be Worth Your Money

The Claim: Microwave Ovens Kill Nutrients in Food

Vitamins and Minerals: How Much Should You Take?

Sugar - good or bad?

I have memories of my father going off sugar when I was in school, because his blood sugar level had gone up. Once he cut off sugar, he was fine. When my mother was diagnosed with diabetes, she also had to give it up. She was then okay.

There has been a lot of talk about how much sugary or sweet stuff we should eat, ever since medical professionals began attributing problems related to heart, kidney, eyes etc. to over-consumption of sugar. We are all having too much sugar, and we don't need that much, was the general refrain.

Some countries are planning a "sugar tax", in order to force people to reduce their intake of sugar.

Here are some of the stuff that I have been reading and hearing:

• The taste of sugar is an acquired taste. Go without sugar for a week, and you get used to that new taste.
• Sugar gives you energy, but it has no fibre, vitamins or minerals. So, it is referred to as "empty calories" . It is better to look for energy elsewhere.
• A number of food items that we eat have sugar in some form anyway, and that takes care of our body's requirement. So, there is no need to take sugar separately, by adding it to tea and coffee.
• Cut down on sweet bakery items, because you are pushing more sugar into your body than is normally required.
• Sugar will only make you obese, increasing chances of diseases like diabetes and heart problems.

So, stop eating sugar?

Some more stuff that I have been reading and hearing:

• All people need not go completely sugar-free. But it is a good idea to minimise sweet items to the maximum extent possible.
• No harm in switching to sugar-free tea, coffee, milk etc., because you are more than compensated by the carbohydrate in other food you anyway have.
• If you need sugar still, jaggery is a better alternative.

What I have done:

• I like sugar and sweets. I am not diabetic, nor am I obese. But I have decided to cut down sugar.
• I am definitely not paranoid. But if I have a choice, I have decided not to add sugar to tea or coffee. I have discovered a new taste, and I am fast getting used to it.
• I am minimising sweet, sugary and carbohydrate-rich food items as much as I can.  If possible, I will avoid them. If I can't, I will take as small an amount as possible.

I am trying to do a balancing act, because that's what so many people are telling me. But the problem is that I am not always able to decide where and when to draw the line.

Let me see how it goes.

(This post is a part of the "Blogging from A to Z Challenge April 2018.")

It's bitter, I love it

The other day, feedback on our office canteen was being collected from some of us. A colleague of mine said in jest, pointing towards me: "Don't collect the feedback from him."

"Why?" I asked.

"Because you will say the canteen doesn't have anything with bitter gourd in the menu. They will decide to have it, and we all will have a tough time," he replied with a smile.

He was joking. But I am quite serious about my love for the vegetable that is popularly hated -- bitter gourd, also called bitter melon; karela in Hindi and pavakka in Malayalam.

It is said that this vegetable has medicinal properties, and if at all anyone likes it, it is because they were forced to eat it, when some health issue cropped up, when they were in their mid-forties or later. But not in my case. I have always liked it, right from childhood.

Most of the recipes have a few steps to reduce or totally remove the bitterness. But since I have no problem with the bitterness, I like it as fried or put in some curry, or plain boiled, or as juice. I know very few people who like this vegetable.

Much after I took a fascination for it, I learned that this vegetable, which is said to have originated in India, and is commonly used in many Asian countries, has a number of medicinal properties.

The most well-known is that it keeps the blood sugar level down, because it has a chemical that works like insulin. It works as an antioxidant, helps digestion, and is generally good for your well-being. Most of properties are attributed to widespread anecdotal evidences, and I am not sure if there is conclusive scientific proof to back them up.

It will be interesting to know if any of the readers of this post, has the same taste as I do.

(Know more about bitter gourd: Practo and WebMD)

(This blog entry is a part of the "Blogging from A to Z Challenge April 2018")

Ayurveda: the first, last or not an option?

When I fall ill, the choice of treatment also becomes an issue that I have to wrestle with, besides the sickness. Should I go to the nearby family physician, or go to the ayurveda doctor?

(For non-Indian readers of this blog, who might not be familiar with ayurveda, it's an ancient Indian system of medicine that bases its treatment method on the nature of the person, and derives its medicines from naturally available substances rather than chemicals. Read more about it here and here.)

When I think of taking the first option, images of strong antibiotics and severe side-effects they produce come to my mind. I wonder should I subject my body to such an onslaught of chemicals?

When I think of taking the second option, images of multiple tablets and kashayams (a bitter and pungent medicine in liquid form) come to my mind. There are so many diet restrictions. Some of the tablets might have to be dissolved in warm water. That's not an easy thing to do, given my crazy daily schedule. 

The clear divide

People who believe only in either of the two have no problem.

There are plenty of people who swear only by ayurveda. They don't go to an allopathic doctor, or take allopathic medicines. Even if they have unbearable pain or fever or an upset tummy, they resort to natural home remedies, rather than reach out for the easily available across-counter tablets.

Maybe the complete cure takes a few days. But they are very patient; and that in combination with their unshakeable faith in this system of medicine, brings them huge amounts of physical as well as psychological comfort, for sure. Their biggest relief is that their body system hasn't been polluted by chemicals during the process of healing.

There are also people who think ayurveda is all unscientific and unproven. They say doctors go by sheer intuition and prescribe medicines that no one is sure will work or not. And if the illness is not cured, another set of medicines are prescribed. They also say that doctors, if they know that the illness is grave, prescribe chemicals-based medicines that are camouflaged as ayurvedic medicines, so that the situation does not aggravate. Once the symptoms have disappeared, the trial and error of ayurveda begins.

Interestingly, many people who go to allopathic doctors, don't trust the doctor or medicines. If you ask them, why do they still go, their reply will be that there is no alternative. On the contrary, people who go to ayurvedic doctors, are never sceptical. They have full faith in both the doctor and the medicines.

Here is what I do

I go by the disease. If it is something that looks quite grave and demands immediate intervention, I go to an allopathic doctor. For example, a major cut or infection or tummy trouble. If needed, I will get a few tests done to get the diagnosis right. If the issue with some muscle or ligament or bone, or to do with the body system in general, then I go to an ayurvedic doctor.

A couple of years back, I was down with fever and body ache. Paracetamol tablets kept the temperature in check. Since the fever didn't go even after a few days, I got a blood test done for dengue and chikungunya. Both turned out to be negative. The fever totally disappeared after about a week. But the pain in the joints didn't go. There was also swelling on feet, more so on the right foot, which didn't subside.

The allopathic doctor told me to take pain killers and apply muscle relaxants, since all the tests indicated that there was no infection or any other serious issue. Then, I decided to head to an ayurvedic doctor. The progress was very very slow. She told me it's arthritic fever. It will take time. I limped around, kept feet at a raised level, so that the swelling will be less. It took as long as three months for me to get back to normal.

I know a person, who when diagnosed with a form of blood cancer, tried out ayurveda and then later had to undergo bone marrow transplant. It's been many many years, and he is hale and hearty. But, I have heard that people have got themselves cured of life-threatening infections, like cancer, with alternative medicines like ayurveda and homoeopathy.

It is all about your health and life. Choose what suits you! Medical treatment is also a lot about your faith in it. So, be it ayurveda or allopathy, believe in what you choose.

(This blog entry is a part of the "Blogging from A to Z Challenge April 2018")

Hospital admission vs home care

In school, we loved to fall sick. That is because, if you were ill, you got an exemption from many activities like attending parades, physical training, compulsory study sessions, etc. Besides that, you were looked after like a king in the hospital.

Post student days, when we are on our own, it's a different ball game. Forget getting admitted, a visit to a hospital for consultation itself comes a big cost, unlike in the school days. Many doctors would recommend umpteen tests as a part of the diagnosis. I won't blame the doctors. Because unlike earlier days, today we have very sophisticated instruments and tests. Why shouldn't a doctor use them, if that can help him understand the symptoms better.

If one's condition necessitates admission, then that can prove to be quite expensive. Of course, if there is medical insurance, that can partly take the load; but then it's still quite a hassle.

I recently read an article in The New York Times Are Hospitals Becoming Obsolete?

It had pointers to some interesting trends. Apparently, the age-old practice was to get treated at home. Only people who were extremely sick went to a hospital. And, not many came back alive.

Gradually, a spate of inventions and discoveries led to an increase in the number of people who visited hospital or got admitted.

But in the US, that trend has now bucked, so much so that the number of hospitals itself is on the decline. 

The maximum number of hospitalizations in the United States was in the year 1981. The article says:

"That year, there were over 39 million hospitalizations — 171 admissions per 1,000 Americans. Thirty-five years later, the population has increased by 40 percent, but hospitalizations have decreased by more than 10 percent. There is now a lower rate of hospitalizations than in 1946. As a result, the number of hospitals has declined to 5,534 this year from 6,933 in 1981."

The clock has come a full circle. Chances of survival in hospitals are coming down, because of various factors like contracting infections. There were 1.7 million cases of hospital-acquired infections that caused nearly 100,000 deaths, the article says.

The new trend is for home care, where the environment is more conducive for a patient's recovery. There is now a better market for home nurses, community health care workers and staff at outpatient centers.

I don't think hospitals will ever become less relevant or they will vanish all together. If one's health condition is too bad, one has to visit a hospital or get admitted. Or else, the condition will deteriorate. I know so many cases, when hospitalization was required to treat the illness. Often hospitalization has given them a new life altogether.

That doesn't mean we run to a doctor for very discomfort one feels. Our body does heal naturally. So, give it some time, before approaching a doctor.

Where home care will work are in conditions that don't require major inventions, like surgery, and constant monitoring. It's quite possible that post illness recovery could be quicker at home than in hospitals.

What are your thoughts?

Dengue - of platelets and papaya leaf juice

My wife was recently diagnosed with dengue fever.

Medical literature says that you must suspect dengue if you have fever accompanied any two of the following symptoms: severe headache, pain behind the eyes, muscle and joint pain, nausea, vomiting, swollen glands or rash. But she didn't have any of them; only fever.

Her illness gave me an opportunity to learn about the disease. Here are some points. I have sourced the following from doctors and web pages of recognized health institutions.

(A diary of my wife's case is below the FAQs)

What is dengue?
It is a viral infection caused by the bite of a mosquito (female Aedes aegypti mosquito), which has previously bitten a dengue patient. The disease is transmitted this way: patient-mosquito-healthy person. The symptoms surface 3 to 14 days after the bite.

When should I suspect it could be dengue?
If you have fever that doesn't go with paracetamol tablets within 2 days, go to a doctor. You may or may not have other symptoms like headache, pain behind the eyes, muscle and joint pain, nausea, vomiting or rashes.

Is low blood platelet count, a sign of dengue?
As a first test, doctors order a blood test. The result would give lot of clues on why you have fever. A drop in platelet count could be a sign of dengue. The normal range is between 1.5 lakh and 4 lakh. But a drop in platelet count is no confirmation of dengue, as the count drops with any infection. So, a specific test for dengue is ordered.

After dengue is confirmed, with the specific test, the disease is monitored by looking at the count of the platelets. Typically, in a dengue patient, the platelet count keeps dropping. How fast and how much depends on many factors like immunity of the person and the severity of the attack.

Blood platelets help the blood to clot. When the count drops, there's a risk of bleeding. So patients are advised even not to brush teeth, because the gums could bleed. There are also dangers of internal bleeding.

The platelet count is monitored every 24 hours. But once the count goes below 50,000, every 12 hours the count is checked. Doctors won't let the count drop. Once it reaches a threshold level -- around 15,000 to 20,000, or even 25,000 -- platelets are injected.

Once the infection is out of the body, the platelet count starts increasing: at first slowly and then rapidly. The rate depends on the general health of the patient.

Is dengue dangerous, fatal?
If detected and treated early it is not. There is no need for panic or fear. A severe form of dengue can be dangerous, and even fatal without early medical intervention. So don't ignore the flu-like symptoms. Visit a doctor.

What is the cure for dengue?
There are no medicines for dengue. Doctors give medicines for the symptoms; and intravenously administer fluids. Patients are told to have plenty of fluids, like water and fruit juice; and have normal food. Nausea and vomiting reduces food intake; and that, combined with the infection, makes the patient weak. The infection lasts about a week. Even after fever is gone, the patient takes about one or two weeks to recover from the tiredness. Fluids, and more fluids, is the only way out.

How beneficial are papaya leaves?
Word has gone around that pomegranate and papaya; and the juice taken out of crushed pomegranate skin, papaya and neem leaves are said to be good for generation of platelets. Doctors merely advise patients to have any fruit. Though benefits of pomegranate and papaya have been well known, the benefits of papaya leaf juice is a new development.

People who have taken papaya leaf juice have spoken of dramatic rise in blood platelet count: for example, from 30,000 to 2 lakh; and from 80,000 to 3.5 lakh, within 24 hours. In Kerala, I am told that not just ayurvedic doctors, but allopathic doctors too, are advising patients to have the papaya leaf juice. I was advised by a couple of nurses to give the juice to my wife. I am also told that tender papaya leaves are being sold at a premium in Kerala.  

In the hospital where my wife was being treated, a patient was being given papaya leaf juice right from day one. But that didn't help much, it looks like, since her platelet count went down to 15,000 and she had to be administered platelets twice. But after she was cured of the infection, the count went up dramatically fast: from 55,000 to 1,30,000.

There is no well-validated and documented scientific backing for this. It's merely an anecdotal evidence. Allopathic doctors are not very forthcoming in giving any credence to this. Ayurvedic doctors say there is an urgent need to research thoroughly the correlation. 

Doctors say once the virus is out of the body and the infection is over, the platelet count will naturally increase with normal food. But most patients tend to have lot of pomegranate and papaya, as part of the diet; and some go a step further and include the juice from crushed papaya leaves. So whether the rise in platelet count is a natural phenomenon or aided by fruit and juice is not clear.

One way of looking at it is: any way the platelet counts will increase once the infections is gone; and the other way of looking at it is: the fruit and juice have played a role. Until a proper scientific investigation is carried out, we wouldn't know for sure the effect.

The effect of any medicine depends a lot on the individual's health. The effect of such remedies vary a lot from individual to individual.

(November 30, 2015 Update: My uncle has been admitted to Chaya Hospital, with viral infection and fever. Though dengue was ruled out, his platelet count is down to 65,000 because of the infection. Doctors have prescribed Caripill, which is made of papaya leaf extracts, in order to boost the platelet count. This means allopathic doctors are recommending this ayurvedic solution.)

How to prevent dengue?
Tough. since it's very easy for a mosquito to bite you, and it's very difficult to keep that one mosquito away. But the following steps could be helpful.

• Don't allow yourself to be bitten by mosquitoes.
• Regularly spray mosquito repellents.
• If you are in a mosquito-prone area, apply some mosquito repellent on your skin. 
• If there are too many mosquitoes, cover your body; and while sleeping use mosquito net, since the effect of the repellent may not last too long. 
• Don't allow water to stagnate. Keep changing the water in plant pots.

Related literature:

• World Health Organization on dengue
• Wikipedia entry on dengue
• Indian Council of Medical Research on dengue
• Papaya leaf juice helps fight dengue (Indian Express)
• Papaya leaf juice helps stop destruction of platelets (The Times of India)
• Neem-papaya juice passes dengue test (The Times of India)
• Home remedies for dengue (Udayavani)

MY WIFE'S CASE

Wednesday, June 5
She got fever on Wednesday (June 5) morning. She had Crosin. The fever didn't go.

Saturday, June 8
After 72 hours, we went to Manipal Hospital at 9 am on Saturday. She was asked to take a blood and urine test. When we got the results at 12.30 pm, we found that all her parameters were normal, except the blood platelet count. It was 1,20,000. It should be at least 1,50,000. She was advised to get admitted to hospital. A specific test for dengue was also ordered.

Manipal Hospital has been seeing a rush of dengue cases. A lot of patients were also being referred to the hospital by smaller hospitals and clinics. There was no bed available and we were asked to call up at 5 pm. Luckily we got. She was admitted around 7.30 pm.

She was put on IV fluids, and given Dolo 650 (Paracetamol) and Folvite (folic acid) tablets. Her appetite had reduced to near nil.

Sunday, June 9
She had nausea and wasn't able to eat solid food. So the dietician ordered semi-solid food like kanji (porridge) of rice, rava, raagi etc, and soup. She was also having pomegranate and papaya.

On Sunday at 5 am, her platelet count come down to 90,000. By evening the fever and blood pressure, which was low, had satablilized.

Seeing the way her platelet count was dropping, I networked among my friends to look for papaya leaves. I thought, if papaya leaf juice has to be taken, then why not early enough, rather than when her condition had serious.

Monday, June 10
On Monday at 5 am, the count dropped to 35,000. In retrospect, arranging for papaya leaves the previous day, was a good move. Since her count had dropped below 50,000, her blood sample was taken at 5 pm. Her count hadn't dropped in 12 hours. It was the same 35,000.

By evening, I got the papaya leaves. Since we couldn't mash it and get the juice then, around 5.30 pm, she took three leaves and chewed them to get the juice out, and spat out the leaves, like bubble gum.

Since she had the leaves after the blood sample was taken, the leaves didn't have any role in arresting the fall of platelet counts. May be pomegranate and papaya and the water she had did.

Tuesday, June 11
The next day, Tuesday morning at 5 am, the count had gone up to 38,000. She had a teaspoon of papaya leaf juice around 11 am. Blood sample was taken at 5 pm. The count had gone up to 54,000. She was also regularly having lots of pomegranate and also papaya, and lots of water.

Wednesday, June 12
On Wednesday, at 5 am, her count went up to 65,000. I thought she would be discharged on Wednesday. But doctor said it was better her count goes up to at least 80,000. No sample was taken in the evening.

Thursday, June 13
Thursday, at 5 am, the sample was again taken at 5 am. Her count had gone up to 1,28,000. May be the juice had some effect in boosting the platelet count by 90,000 in 48 hours. She was discharged yesterday around 2 pm.

She is very weak. Recovery will take a lot of time. She will have to take a lot of fluids, and may be another round of papaya leaf juice.

MY SUGGESTIONS:

• If you get fever, especially when there are lot of dengue cases in your city, don't ignore fever. If it doesn't subside within two days, go to a doctor.
• Don't panic. Even if the doctor suspects it's dengue, and later it is confirmed it's so, don't panic. Do get admitted to a hospital, where your platelet count can be regularly monitored.
• Drink lots of fluids -- water and fruit juice.
• Have lots of pomegranate and papaya. If you can get papaya and neem leaves, do arrange for them. Wash the leaves very well. Mash them in mixie with a little water, filter it, and have the juice. Even if there may not not be any good, there won't be any harm.
• Recovery will take its time. Eat whatever you feel like. Drink lots and lots of fluid.

Simple tips to be trim and healthy

Obesity is a major problem. People put on weight for various reasons -- mostly due to two factors: one, excessive and irregular eating habits, mainly fatty food; and two, lack of exercises. There are also cases where neither of the two are responsible; it could be because of the peculiar body constitution, in which nothing much can easily be done.

Food gives us nutrition for the body to grow; and it gives us energy to work and play. But it can also wreak havoc, if you don't keep a watch on what you eat.

Food dipping in ghee, butter and oil are good for children. So too meat, even red meat, for those who don't mind eating them. Fatty food pack lot of energy in them, and they get expended while the children play and work. But that's not the case for grown-up people, especially those above 30 years of age. At that age, the body also loses its capacity to burn the fat.

As we grow older, there should be increasing regulation of the food that we eat. Avoid meat, especially red meat. Fish is good, but avoid the fried form. That should take care of most health issues. It's not easy as it sounds.We are talking of nearly monastic diet; food that has minimum content of fat, salt, sugar and oil.

If one tries this out, with some determination, the effect on health can easily and immediately be seen. What works best is not complete ban on these villainous food additives, but regulation. Avoid them most of the time, but indulge once in a while. It'sn't easy; but with some steely resolve it's possible.

To be healthy, there is no need to go to a gym and employ a physical trainer. Just make sure you do enough of physical activity - anything from getting up from chair and walking around, to climbing stairs, to washing clothes to mopping the floor, to going on a long walk. Additionally, do some 20 minutes of breathing and stretching exercises daily. Rather than vigorously exercising for long hours once in a while, it's better to exercise in short spells more frequently.

Here's an article from New Scientist that says in order to lose weight one mustn't skip food, but cut down on fat.

Viral infection

There was no blogging or surfing of blogs. In fact, there was nothing much I could do other than lie inactive having been overrun by a viral infection.

There was all the sign of the impending distress on Sunday, and high fever set in the next day. It continued on Tuesday and Wednesday; three days spent doing nothing other than sleeping.

There wasn't energy to even sit up. The distaste caused by the antibiotics brought down food intake to almost nil. And to make matters worse, the medicine side-effects ensured that tummy too malfunctioned.

I woke up to a semblance of normality on Thursday. And on Friday night, I felt fit enough to get on to my favourite web world of blogosphere. The big task ahead: sifting through the pile of emails.

But some cheer on the cricket front: India seems to be doing well at Bristol. Chasing India's 329 for 7, England are tottering needing 130 runs with 5 wickets and 16 overs remaining. I won't have the energy to sit through the night. Hope our boys win!

Fever scare in Kerala

People are dying in Kerala due to fever. Unimaginable, but true. Over 250 people have died in the last 3 months. Everyday on an average of 5 to 10 people are dying due to fever. Now, it is not just fever; the patients are reporting rashes and wounds as well, according to Malayala Manorama.

It is believed that this is a disease called chikungunya, caused by a virus spread by mosquitoes. This is not the first time Kerala is in the grip of fever. In the last three years it was rat fever and Japanese Encephalitis.

I don't think any state has ever called in the Army's medical personnel to help fight fever. Reactions like "this is just a media creation" don't help. The threat is real. During my recent Kerala visit, I found six people whom I know down with chikungunya. Two of my relatives in Bangalore have now decided to postpone their visit to Kerala because of the epidemic.

This is worrying because Kerala is known for its clean environment and high health standards. Public health indices are commendable. People are highly educated and well-informed. Even the remote villages have public health centres. People have good access to doctors and medicines. Basic infrastracture in smaller towns and villages is much better than in any state in the country.

People say the fever started off in areas where there are thick rubber plantations. The workers who scrape the trees as part of the process to obtain 'rubber milk' do not dispose the water used or leave them stagnant in nearby areas. I am told it's an ideal place for mosquitoes to breed. And when rain comes, there are puddles of water all around for the mosquitoes to multiply in infinite proportions and thereby for the virus the spread.

This is by no means a scientifically validated cause for the epidemic. But such instances are being pointed out to drive home the point that people, inspite of the perceived high levels of awareness, bother little to ensure cleanliness of the environment.

Many are cynical. Instead of approaching this issue scientifically some say it is a wholly exaggerated scenario; a few others say it is part of a terror plot. Instead of taking preventive measures some are busy recalling how they saw mysterious planes flying low, which they say were dropping "strange powders".

Expecting others, including the government, to clean the environment is one thing. But primarily the citizens have to be much more cautious and take steps to keep the surroundings clean. Indeed the state has to undertake an extensive cleansing drive. Also, the scientific community has to take this up and find a way out to get around the problem.

Sinusitis

A common cold and viral fever never got as worse as this. For close to a week, I was down and out. The cold set in Tuesday last, progressively got worse, and ultimately infected the sinus. The condition is called sinusitis: an inflammation of the sinuses which are nothing but small air pockets in the facial bones. Anyone who has been through sinusitis would agree that it’s awful to get it. The splitting pain that radiates from the forehead is unbearable. There is severe pain if one bends down, even if one moves the eyeballs to either side. Sinusitis is easily among the worst forms a common cold can aggravate into. A mixture of steam inhalation combined with mild antibiotics has finally brought me comfort.

Tourniquet: Bad advice for a snake bite?

We have learnt that applying a tourniquet is the first step to be taken in case of a snake bite. But here is a different take on it ....

Mike Edwards, 46, was bitten by a timber rattlesnake while working on his farm. The bite was (very) severe... As Edwards and his wife, Andrea, waited for the ambulance to arrive, a good Samaritan tried to help using advice gleaned from Hollywood -- applying a tourniquet.

But a toxicologist who arrived on the scene said the tourniquet just kept all of the venom in one place, and it swelled, which made it harder for the antivenin to get to it. It could have cost his life. Edwards' condition was critical by the time they arrived at the hospital and his blood pressure was dangerously low, his wife said. Mike said he lost vision at one point and was convulsively twitching.

Middle Tennessee Medical Center's Dr Kevin Beier, who specializes in emergency treatment, said venom is used by snakes to break down the tissue of prey to make them easier to digest. "When you trap the venom, it causes tissue damage and necrosis (tissue death)," Beier said. Beier said there are rare circumstances when using a tourniquet would have helped, such as in the cases of the victim going into shock and to slow the spread of the venom.

But Beier said the method of cutting a wound and sucking out the venom is never recommended. "DO NOT DO THIS," he said. "That's been shown not to have been of any benefit and it can increase the effect of infection or damage." Full story

So, what about the first aid we learnt? May be some doctors could comment on this...

Young hearts at peril in India

"In sharp contrast to the West, as many as 40 per cent of those who get heart attacks in India are below the age of 40. In North America and other Western countries, the figure is only four per cent."

Alarming... More here