Tere Bhane Sarbat da Bhala

Health for All

Dear Readers,

First of all, I wish you all ‘the best of your health’ today, tomorrow, and always. The ultimate way to enjoy your life and wealth is to be healthy, to be free from diseases, to be free from medicines, hospitals, chemist shops, medical laboratories, doctors, and all types of sufferings. To understand the concept of health, let us have a glimpse of the evolution of life in this universe.

Unicellular organisms were the first to come on this earth as living beings which probably included viruses, bacteria, ameba, etc. Human beings came much later. So, this earth originally belonged to microorganisms, and we all including animals and human beings, came subsequently along with the evolution. To coexist on this earth, we will have to come across these microorganisms several times during our lifetime and it is important to understand this relation and their behavior towards human beings. Suffering in humanity probably started with the arrival of human beings on Mother Earth. The people must have started looking for remedies since then. Thus the practice of medicine is time immemorial.

In a little more than a century, with the understanding of modern science, human beings started understanding sugar, proteins, fats, vitamins & minerals (growth of Chemistry, Biochemistry, Organic Chemistry), medicines (Pharmacology), bacteria, protozoa, viruses, etc. (Microbiology, Parasitology, virology, etc.), X-Ray, Ultrasound, CT scan, MRI, Nuclear Medicine, etc. Simultaneously various medical, surgical, and interventional sciences grew in parallel to the growth of industrialization, housing, infrastructure, vaccines, urbanization, mobility, communication, etc. Also, with the advancements going on, the levels of treatment kept on progressing from a self-learned doctor, Medical Graduate, Specialist, Super Specialist, and further on and on. With further understanding of molecular biology, genetics, and oncology, there is an exponential growth of medical disciplines including tropical medicine, rheumatology, oncology and their various branches, hematology, intensive care and its ramifications, and emergency medicine etc. Thus, beyond doubt, today’s human beings including both the patient and the ‘health care provider’ are the best equipped in the entire documented history of human beings on this planet to handle health and disease.

We do understand that “Health is Wealth”. So, the next question comes if the most important possessions in our life are the money, jewelry, and ornaments to be kept in our lockers or the real estate documents to be kept in safe custody! No doubt that all these components of life are very important and sometimes even indispensable. But still, another important issue that needs to be answered is what we all need to enjoy these above-mentioned earnings and wealth of our life. The simple answer will be Health, Good Health, and nothing but The Best of our Health.

So, how health can be preserved or acquired?

Health is a lifelong concept that starts from the day of conception. Thus, the day a couple plans to welcome pregnancy: they must ensure a healthy weight, a healthy diet, and a regular physical fitness schedule that is a healthy body and mind to receive a brand new soul in this world. The best will be to have an examination by an obstetrician along with a few investigations to ensure normal HB, Thyroid, Glycemic status, vitamin D & B-12, kidney and liver functions, etc. All unhealthy habits and abnormal investigations should be corrected before we welcome a new companion to our lives. The ill effects of alcohol and tobacco are well known to us and need not be allowed to enter into this beautiful phase of our life. During pregnancy: a good diet, exercise, positive and happy attitude will add to the fruitful outcome and beginning of a new era of life. For the newborn baby: complete vaccination, prescribed vitamin supplementations, breastfeeding, and addition of other food items at the right time will help achieve ideal health status. Regular sports activities and exercise schedules should be part and parcel of the formal education program from the beginning of schooling in every society.

Simultaneously also starts the concept of life and diseases. Broadly we can divide various diseases into two types: Acute and Chronic. Acute diseases mean our day-to-day problems like fevers, diarrheas, coughs and colds, injuries, etc. Thereby meaning that the problems which have started just recently and are going to be over soon that is within days or maybe weeks. Chronic means the medical issues continuing for months, usually more than six months, and are going to last for months, or years or may be lifelong. Examples could be High Blood Pressure, Diabetes, Arthritis, Asthma, etc. Our approach and outlook in these situations have to be appropriate and matching. Acute problems could be short-lasting but also sometimes catastrophic like covid, dengue, malaria, accidents, etc.  On the other hand, chronic problems may be harmless and silent but can have grave consequences in the long run like diabetes, high blood pressure, obesity, etc.

With experience, people do learn to manage their day-to-day health problems like headaches, fever, aches and pains, tummy upset, common cold etc. While living with their chronic diseases, people learn self-monitoring and management under expert advice. These learnings are very useful and mandatory to manage your health issues in a proper scientific and professional manner and maintain good health lifelong. There is no harm in utilizing home remedies and over-the-counter (OTC) available medicines for the issues you understand well about your own body. Unfortunately, almost all the types of medicines are available in our country as OTC thus making this self-treatment turn into disaster many a times. Another bigger issue is the unqualified practitioners available in every nook and corner of our country. They know nothing but treat everything. Another category is of the self-styled medical advisors who work in health setups as non-medicos but love to treat and advice on all medical aspects of life. Paramedicals, and even medicos crossing their professional boundaries of competence, many a time complicate the diseases rather than giving relief.

I would like to share two true stories with you

1. During my residency days, a youngster had a headache treated as per their understanding at their home. A senior radiologist being their acquaintance was consulted instead of a physician. To oblige the friend, probably with all good intentions, time was fixed for a CT scan of the head rather than consulting a clinician. After the CT scanning, the patient was taken to an emergency for treatment. This disease being an acute bacterial meningitis in its’ very severe form could have been detected by the clinician within minutes and thus initiated on treatment while investigating simultaneously. Being treated like a VIP but going through a CT scan, a wrong route, caused a delay in the initiation of the antibacterial injections and the patient was lost. In these situations, the time to start the treatment at the earliest is the most important parameter for the best outcome.
2.  Will share another true story of a middle-aged learned, well-placed, high-profile lady, who was getting treatment for her neck pain and arm pain from a physiotherapist for a few days. As the pain was not getting relieved, she approached the emergency room and refused to show it to the senior physician on duty and insisted on calling the orthopedics on the advice of her physiotherapist. An Orthopedician was called and by the time he examined the lady, it was too late as it was an ongoing heart attack and was being treated by the wrong person. Lady died within no time as precious time was lost. So, here comes the importance of identifying the usual day-to-day health problems versus life-threatening conditions, where an experienced physician will be of utmost help.

Our home gadgets like Fans (a few thousand rupees cost), A.C and fridge (a little more costly), automobiles (costing up to lacs or maybe more), etc. are not repaired by a single mechanic as the technology involved in each of these machines is different. Each time there is a problem with these gadgets; you pay a few hundred odd rupees and get these equipment repaired by the concerned appropriate expert with total peace of mind. However, when the question comes to the repair and management of our body (cost one can imagine if it is in lacs, crores, or more? or otherwise), we seek opinions from anybody. Anybody means a non-medico family member, friend, patient, neighbor, karyana store manager, and most importantly our neighborhood chemist to name a few. Legally in our country, to prescribe any medicine, a person has to pass graduation in Medicine. No Chemist, Nurse, Dietitian, Physiotherapist, dental hygienist, optometrist, audiologist, O.T. attendant, etc. is supposed to prescribe the medicines. No doubt that all the patients in hospitals including the sickest of the sick are treated by the nurses and other members of the paramedical team from time to time, but that treatment is given only on the advice of the treating doctors. Various physical treatments and rehabilitation are performed by Physiotherapists in hospitals, but all that is done on the prescription and professional guidance of the treating specialist/super-specialist doctors. All the dietary advice for various diseases is given to the patients by the dietitians under the advice of the treating doctor. Similarly, all the prescribed medicines are given to the patient by the Pharmacists but they are given as per the advice of the treating clinician. Thus, the roles and their limitations for each of the paramedical persons in health care settings are well defined to work as a team member to deliver their best while taking care of fellow human beings. Not only paramedicals every doctor including specialists and super specialists has their defined fields of operation, and any patient having issues beyond their discipline are referred to the appropriate expert for management. While performing their jobs after acquiring the minimum desirable qualifications, all these paramedicals keep on learning, growing, and acquiring knowledge. In fact, in modern medicine, the treating team is supreme while working in coordination and contributing their best from their learned experiences.  So, with the available expertise in the medical field, it is desirable to go to the right clinician at the right time to lead a happy and healthy life.

Dear readers, ‘Health is Wealth’. All the valuable possessions of our life become meaningless if we lose our health. Taking care of the best gift (our body) given to us by almighty is our utmost responsibility. Even the best of the best players in this world have coaches to guide them so that they can play the game well and reach the highest medals and positions in their game. Let us all, also have a dependable, knowledgeable, sincere, and honest guide/ health coach who helps us in making health-related decisions from time to time. In my coming blogs, I will be discussing common health-related issues in a very simplified and practical way so that I can help my readers understand these issues that commonly affect our society. Timely and well-managed diseases can help us to live long and live happily. Sat Shri Akaal.