health & stress

1

An A

udio

-Vis

ual P

resenta

tion

A

n A

udio

-Vis

ual P

resenta

tion

Dr Bapuji Balijepalli BSc, M B B S, ND

Revised II Edition

PREFACE

This book, is a revised version of compilation of Slides of Power Point presentation, conducted by me for Senior Executives & Professionals. It is an Audio-visual effort on Health & Stress management with interesting anecdotes from day to day situations. Contents of the slides are based on Modern Medicine (Traditional Medicine in West),

Naturopathy & Yoga. The book enables Senior Executives, Professionals and influential People in the society, a ready reference, instead of searching for the desired slide in the Laptop. The index in the book helps locate the topic of their interest and go through when stuck at the airport & during long flight travel. Through this book and the lecture sessions, I endeavor to share vital knowledge with key personalities of the society so that the importance of Lifestyle Management is realized and it is intended to help and educate all the patients by bringing this book and CD. I may mention here that it is not a commercial venture. So says Alexis Carrel: “To live is not sufficient; we need also the joy of living; and the joy of life depends on Health. Above all, we need the Health that embraces the Body, the Mind and the Soul”. This book is my humble contribution towards collective efforts by crusaders to ensure ‘The Joy of Living’ for one and all.

Dr Bapuji Balijepalli 2

Authored & Published by Dr Bapuji Balijepalli BSc, MBBS, N.D

Nature Cure Health Care Center,

Kantisikhara, Punjagutta,Hyderabad-500 082.INDIA

Tel: 91 40 23418307, 23400601, 66627212

Email: [email protected],

Website: www.drbapuji.com

Designed by VenChars Media Communication Pvt Ltd

Phone : 91 40 27895971,72,73.

www.VenChars.com

Printed by Pragati offset Pvt Ltd,Hyd.

www.pragati.com

II Edition - 2012

2000 Copies (total number of slides 251)

Price: `600/-

US $ 30/- outside India.

3

What is New added in this book

• Patient’s Concern. • Patient’s expectation. • Indifference of Medical field. • Doctor’s Conscience only can

save the Patient. • Symptoms of Heart attack. • What tests to be done. • How to take a decision for

STENT,CABG or Medicines. • Today’s approach in

Cardiology. highly tainted. • How to take Insulin? Today’s

Pens are a big Hoax. • Every alternate Patient is

unjustifiably put on Thyroid Hormone.

• How to reduce Weight. • How to reduce Salt in Diet. • List of colors & Food additives that cause Cancer • Exercises for Neck and Lower back. • When should Spinal Surgery

be taken up. • Chemotherapy and Radiation in

Cancer treatment. • One should learn to accept ageing and related

problems and some of the irreversible, incurable diseases & terminal Cancer and accept gracefully ultimate eventuality.

Educated Patient and his family, have to take this tough decision, instead of getting tortured in Intensive Care Unit.

mailto:[email protected]

http://www.drbapuji.com/

Index- 4-9

Inner Cover- 10

Hippocratic advice of treating Patients 11

Scope of Naturopathy & it’s future 12

Life style is the only key to Health 13

Preventive Maintenance is wiser than Crisis Management 14

I am for my Patient 15

Treatment systems are not/faulty 16

Today’s Problem of Doctor & Patient- 17

A Conscious approach in patient’s treatment 17

Physical Health has a lot of bearing on Mental stress- 18

Very poor status of Health of today’s young Adults – 19-22

Family Physician concept forgotten- 23-25

Specialization- Advantages and Disadvantages- 26

Impact of Ill-health on Organizations and on its Employees- 27

A reasonable Health & right mental attitude are mandatory- 28

Health is an individual’s responsibility- 29

Biological ageing- 30

Life Span improvement & its impact including on USA and others- 31-37

Population of elders & Population ageing and its impact- 38-40

Criteria of reasonable Health for Elders- 41

Story of a 70 year old man- 42

Moral of the story- 43

Life expectancy versus Quality Health- 44

Impact on individual’s family due to ill health- 45-46

Alexis Carrel- “To live is not sufficient; we need also the joy of living… 47

Complexity of Human Body; - 48-50

Criteria of diagnosing Coronary Artery Disease- 51-53

By-pass surgeries, Angioplasty, useful as temporary measures- 54-55

PTCA (Angioplasty) and Stent- 56-59

Index Health & Stress management

Contents

4

Slide/Page

Index contd..,

Cardiologist’s ploy for PTCA & Stent- 60 Stent has a very limited use but most misused today- 61-66

Multiple stents damage Heart Muscle irreversibly- 67 Are Indians Guinea Pigs for Drug trials without their knowledge?- 68 Bio-degradable Stents BDM –Much better if Successful - 69 How can there be a Mechanical solution for metabolic disorder- 70-71

Diet, regular exercise, Yoga & Meditation + monitoring and medication - only solution- 72-74

Ignorance of Medical Teachers- 75

For reasonable Health, a little effort needed ,as it is not a purchasable commodity- 76

Medical achievements and commercial interests with unethical approach are the order of the day- 77-83

Efficient Physician 84

Approach of Hippocrates, the father of Modern Medicine- 85

Biological intricacies too complicated, Perfect Doctor-none, No dearth of money for a sincere doctor- 86-87

Pessimistic approach of today's educated patient and his ignorance & misconceptions about: 88-95

Normal BP- 89-90

Pulse- 91

Temperature- 91

Blood sugar - 92

Walking after dinner, Bath after dinner: contraindicated- 93

Proper use of sufficiently thick Pillow and only 2” Mattress- 94-95

Lipids Profile- 96-102

Importance of Good and Bad Cholesterol - 97-98

To improve Good Cholesterol- 99-100

Low Cholesterol is bad for health- 101

Triglycerides are not important<500 mg/dl - 102

Fruits & Raw foods- that improve HDL- 103

Health & Stress management

Contents

5

Slide/Page

HEALTH – Physical & Mental Health STRESS 104

Mental Health management, 5 important aspects- 105-106

Physical Health management-IV important Steps 107

I Step Annual medical check-up for everyone after 30 years of age- 108-110

Patients views in India about a “Competent Physician”- 111

Commercial trend of corporate hospitals- 112

Outrageous prescriptions of Diabetic Medication and Insulin- 113-117

Irrational and unnecessary prescription of Thyroid medication- 118-121

II Step (i) Common day to day ailments –How to go about – Treatment- 122-126

Fasting therapy- Fundamental basis - 127-129

“Nature’s Healing Power”- 130-131

Not all allopathic medication have to be taken after food- 132-133

USA-Scenario- Treatment in USA quite disappointing - 134-139

Chemotherapy and radiation curative in only a dozen type of cancers- 140-142

Human body’s meticulous defense system- 143

A proper temperature chart – gives a clue to the type of fever- 144 (ii) Chronic diseases- 145

A) Birth defects in children – How to prevent?- 145

B) Hereditary Diseases – What precautions by the individuals? – 146-147

How to reduce Bad Cholesterol by Diet– 148

Should not stop Vegetable oil consumption- 149

Weight Charts- 150-151

Obesity is a disease not a sign of Prosperity- 152

How to reduce Overweight- 153


Contents

Index contd..,

6

Slide/Page

Allergic problems-Diet has a role-Modern Medicine's Ignorance – 154-155

What is an autoimmune disease?- 156

Specific Diet restrictions in Allergic and Autoimmune diseases - 157-159

(iii) Acquired Diseases- 160 (iv) Degenerative diseases Infections- (A) Acute & Chronic (B) Metabolic disorders- 161 (v) Diseases of Unknown reasons- 162

III Step How to assess one’s own Health- 163

IV Step Factors that preserve & restore – HEALTH- 164

SIX FACTORS- 165

1st Factor- Regulated daily routine – importance- 166-170

Solutions for people with shift duties, working in BPO companies – 170

2nd Factor-Good Dietary Habits- 171

Criteria of a Good diet- 172

Untimely food is a poison - 173

How many times should one eat in a day?- 174-175

How to reduce Salt in Diet?- 176-177

Non vegetarian food – How often ?- 178

Fast on liquid diet one full day in a week, contraindications - 179-180

Water intake- 181-183

Hazardous ingredients in our daily food- 184-187

Dangerous additives in our daily food (Tables) 188-190

Refrigerator- Not a garbage bin, What to preserve and what not to?- 191-192

Only certain foods to be cooked under pressure in a pressure cooker- 193


Contents

Index contd..,

7

Slide/Page


Contents

Index contd..,

Microwave - good or bad- 195

Fenugreek (“Methi”), Bitter gourd juice, Blackberry (“Jamoon”)- 195

Whether useful in Diabetes?- 195

Garlic in reducing Cholesterol and preventing CAD-has got any role?- 195

“Hydrotherapy” Drinking 1 ½ - 3 liters of water early morning –not good for health. - 195

Myths about Oil pulling and Auto urine therapy- 195

3rd Factor- Regular Yogic Exercise: 196

“No Yoga, No Peace”- 197

Benefits of regular exercises- 198

Definition of Luxury- 199

Conventional exercises impractical - 200

How much we over eat and how less we exert- 202

Criteria for an Ideal exercises regimen- 203

“25 minutes Yoga for You” – briefly- 204

Caution before taking up “25 minutes Yoga for You”- 205

Incidence of Lower Back and Neck problems, has drastically increased during last 3 decade- 206

Reasons- 206-208

Spinal root pains causing confusion for the other Diseases- 209

Spinal Exercises a must for everyone after 20- 210

Surgery in Cervical and Lumbar problem indicated only when… 211

Spinal exercises for Elders - 212-213

Spinal exercises for young adults and middle aged - 214-219

“25 minutes Yoga for You” – pictorial details- 220-223

8

Slide/Page

4thFactor- Avoiding indiscriminate, excessive medication- 224

Harmful effects of Drugs- 225

Drug situation in India- 226

WHO has fixed only 350 Generic drugs(2010) 227 1,70,000 of various combinations in the Indian Market- 228 Multiple drugs – Harmful- 229

“Every pill has an ill” - 230

5th Factor - Habits and addictions - 233

Excess tea & Coffee- 234

Cigarette smoking - 235

Mouth fresheners containing beetle nut, flavoring agents etc.- 236

Narcotic Drug addiction- 236

How to give up an addiction? - 237

Limits of Alcohol- 238

Alcohol and liver damage-How to prevent?- 239-240

6th Factor- Philosophy of Life - 241

Summary- 242-243

Objective of the whole session- 244-246

A verse from “Bhagavatham”- 249

About the faculty- 250-251

Contact details- 252

To organize this half a day program – details- 253

Acknowledgement & Disclaimers - 254


Contents Slide/Page

Index contd..,

9

An A

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tion

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Revised II Edition

Dr Bapuji Balijepalli BSc, M B B S, ND

11

*Hippocratic way of treatment was: “Primum, non nocere”, which is a Latin phrase

that means “do no harm” by way of treatment.

Naturopathy is the closest to this principle. Treating Patient as a whole entity, is the crux of any treatment of healing rather than only treating multiple specific

symptoms of diseases.

HIPPOCRATIC ADVICE OF

TREATING PATIENTS

*Hippocrates is considered as “Father of Modern Medicine”(Traditional Medicine in west)

Values, Ethical approach with Compassion in Medical practice, keeping in view patient’s affordability while advising, prescribing and treating, are most important factors, Doctors have to keep this in mind.

12

Naturopathy is mainly a preventive system and is effective only in tackling:

1. Common Day-to-day ailments

2. Most of the chronic diseases and

3. Guiding people in “Life Style” management.

Naturopathy has no role in treating Congenital diseases, Acute problems, Serious Injuries, Medical and Surgical emergencies. This is where the Alternative systems should be capable of diagnosing the above conditions to know their limitations, which is lacking today due to non exposure to clinical cases during training.

Colleges, teaching Alternative systems, have to realize this drawback and take up the help or co-ordinate with Modern Medical system (East).

For this, Egos between the systems have to be kept aside in the interest or safe recovery of the patients.

Scope of Naturopathy and its Future

13

*Life style management is the only key to maintain a reasonable Health to avoid chronic diseases.

Hence,*Annual check up with basic tests, is the only way to keep a watch and diagnose early in Acquired Chronic diseases. Hereditary diseases also to be identified, on which Patient does not have a choice, as one could not have chosen one’s own Family! This is necessary to manage with minimum medication or Surgery if needed and to avoid complications later.

Sophisticated and expensive tests, come later when a diagnosis is not possible after thorough Clinical examination and routine tests. Then only Interventions wherever needed, of course are unavoidable.

LIFE STYLE IS THE KEY FOR GOOD HEALTH

* Ref- Page/slide-165

Life style is the key…...

By the time Heart attack occurs, ¾ damage is already done which is irreversible. It’s only a compromised life subsequently. Angina, Chest pain due to decrease of blood supply to heart muscle is only the tip of Iceberg of CAD.

* Ref- Page/slide108-110

14

Bypass surgeries, Stents, renal and gallstones removal and other surgical interventions etc., are only palliative solutions in emergencies, only to a limited number of cases. Some diseases occur for unknown reasons like, autoimmune diseases, Allergic problems, Metabolic disorders, diseases by birth, where Surgery / medication would be required on regular basis with dietary restrictions. Most of these diseases also can be minimized and respond to Life style management.

PRVENTIVE MAINTENANCE IS WISER THAN

CRISIS MANAGEMENT

This is the only solution to cut down the Medicare costs for the patients and as well as for the countries including the so called most developed ones, which are struggling to meet the Healthcare costs.

*It applies to every field, particularly in Medical field.

Life style is preventive maintenance…...

*Basic established concepts never change in any field.

I AM FOR MY PATIENT

15

My concern today, is for my Patients, the way they are being treated unethically and commercially by both who practice Modern medicine and Alternative Systems.

People feel that Comforting, caring and consoling the patients and their family members, has become the most uncommon thing today. Nobility of the profession has been gradually disappearing. It is very unfortunate that Patients do not have a choice except to concede with faith in the Doctor or to submit due to panic, induced by the Doctor. Fear is the key to exploit patients is everybody’s perception who have no choice but to meet the high cost Medicare, putting whole family’s very survival in jeopardy. Dr. Bapuji Balijepalli

Medical treatment has worsened…...

16

It may be noted clearly that I neither discourage, promote nor challenge any particular System of Medicine or Specialty. Also, I do not undermine the importance of Private Clinics, State run or Corporate Hospitals. High tech equipment and tools used in medicine and modern drugs from Pharmaceutical Industry, are very much needed. However, some consideration for “the ailing” is quite Crucial in the treatment of the Patient.

Medical field is good but people…... It is a general feeling that “Treatment Systems” including Modern Medicine are never faulty. It’s about the majority of people who are in the profession, the way they are practicing and the way Physicians are trained today in India. I am given to understand that in Private Medical colleges after final year MBBS, 85% trainee doctors are writing dummy case sheets without seeing patients clinically as there are not enough cases. I understand that to shift to a Government Hospital, the candidate of Private Medical college can not afford the huge expenditure involved to get “no objection certificate” from his own college. Further, Govt. hospitals can not accommodate all the Private Medical college candidates. The way the Specialists are practicing in Corporate hospitals in every city, is beyond the reach of common man. Government hospitals are understaffed with mostly frustrated Doctors to deal huge numbers with grossly inadequate facilities and defunct equipment.

There is no value for life in India, Doctors cannot be regulated by laws. It will lead to what is

happening in USA, never will be able to bring down Medicare cost.

Policy makers are not bothered at all to allocate sufficient funds.

Where can the patient go? This is what hurts Patient the most.

Todays problem of Doctor & Patient

Patient & Doctor problem…...

17

Patients expect from Doctor: “A pill for every trivial discomfort”. This has to be discouraged. “Every Pill has a side effect” is an age old saying and holds good even in present times. Sometimes, treating Physician can not even detect, a serious side effect, was due to the pill given or interaction with multiple other pills given. One can not even make out why patient became serious or died. Keeping patients and their family members informed while the treatment is underway, either in the Operation theatre or in the intensive care, is the need of the hour. It takes only a graduate doctor, trained for this purpose to take up this responsibility. Hope, the Hospitals implement this important aspect of requirement. Unfortunately, the patients as well as their kith and kin do not digest the information of the actual condition of the Patient and always expect a positive or favorable prognosis, all the time. This is precisely the reason that majority of the Doctors are reserved, withdrawn and cautious, so much so they hesitate to offer comforting words.

Physician is not God and no system of Medicine, is perfect to deal with Man and all his ailments even in 21st century.

Today’s Health of Young…...

Dr Bapuji Balijepalli 18

If anyone wakes up with Sinus

Headache, that person would be

irritable with Spouse and Children

at home, tend to be rude and

abusive to subordinates at place of

work, indifferent to colleagues, and

non-receptive to the Boss!

Physical Health has a

considerable bearing on Mental

Stress; the other side of the Coin

is being dealt with here in this

presentation!

An Individual suffers from 4 to 6 of the following list

of the Diseases by the age of 30 years and above

* Cervical Spondylosis

* Lumbar Spondylosis

* High Cholesterol

* High Blood pressure

* Heart Attacks

* Diabetes. M

* Over-weight

* Osteo-arthritis of knees

* Insomnia

* Menstrual disorders

* Chronic Digestive problems

- Heart-burn, Acidity, Chronic Indigestion,

IBS, Constipation & Piles

* Respiratory Allergies –

- Rhinitis, Pharyngitis, Snoring, Ch. Sinusitis,

Allergic Bronchitis, Asthma


19

http://www.clipartguide.com/_pages/0511-1108-0818-3421.html

Health ?

Stress

Net Result – One is leading a highly

compromised Life.

As long as one is able to move on both legs, One never realizes the importance of Health until that person gets bedridden.


20

Medical Statistics of Government of India

- In 1950, the average Life span

of an Indian was 37 years.

- In 2012, it has improved to 67 years.


21

This improvement has been possible, thanks to the control

of Communicable Diseases through Immunization and

various Health programs with the help of WHO.

Though an Indian lives up to 67 years, he is down

with Multiple Chronic problems, right from the age of 30

plus. Similar situation is seen in other developed countries

According to “Campbell’s Law”

Statistics

Statistics is a good tool,

provided used wisely but

remember Statistics is like a

Bikini, what it reveals may

be quite amusing. But, what

it conceals is more Vital.*

12


22 * With due apologies to Ladies. Please take it in the lighter sense

Where are those family Physicians

Today, the multiple Health problems of an individual are not tackled by a single Doctor. The educated patient himself decides to go to a Specialist.

How can a patient know whether he should undergo a battery of tests or a particular Surgical procedure, not justified by the Doctor. Who should co-ordinate the 4 or 6 different prescriptions of the Specialists ?

Usually, a Specialist never takes into account what the other specialists have prescribed. This is because a Specialist looks only into his field of Specialization.

80 % Lab investigations & Surgical interventions are unnecessarily done all over the world in Modern Medicine. This is a well known fact.


23

?


24

Reasons: Defensive Medicine, to meet the Capital cost, Interest repayments, Overheads costs, other expenditures like “Referral Fee” to other doctors and incidental expenses of Corporate Hospitals. Cost of Medicare is bound to steeply rise in near future.

It is the role of a Family Physician, Company or Doctor working for an organization, to help the individual in such situations. Doctor should also be in a position to discuss, if needed with the Specialists concerned on behalf of the patients.

Family Physicians have become extinct Role of Family Physician…...

25

There are not many competent Physicians available today to offer advice as to what is to be done, where to go, whom to consult, for the patient’s multiple health problems. Family Physician also to suggest whether a Specialist or Surgeon is competent.

This is the result of too many Specializations and

Micro-Specialties even though they are essential.

How can a patient or Patient’s relatives decide as to whom to consult First ?

A well qualified “Basic Physician” can diagnose and advise on the problems of all specialties up to a basic level. Beyond that, one should be in a position to refer to a competent Specialist.

The Family Physician should be capable of recognizing Medical and Surgical emergencies, Serious injuries and immediately render First aid, and refer and shift the patient in time to relevant Specialist in a Hospital with adequate facilities.

Specialization–its advantages and disadvantages

While treating multiple ailments, Human body cannot be divided into water tight compartments. A Cardiologist can not prescribe Beta - blockers for high Blood pressure Patient, when he has respiratory allergic problem or on high dosage of Diabetic medication including Insulin. The patient’s Bronchial Asthma can get aggravated or his Hypoglycemic symptoms can be switched off respectively. This can lead to a serious condition or a Fatal situation.

Specialization & problem…...

Specialization for every field including in the Medical field is highly essential to make progress – in speedy diagnosis of the problem, in refining techniques, reduce the costs and the risks. It is also needed to explore & to find solutions for the unsolved problems of the past.

It does not mean that the basic concepts have to be forgotten.

The above situation is like- “What left hand is doing, the right hand does

not know and vice versa”. When half a dozen Specialists are involved in

treating a patient without discussing amongst themselves, what would

happen to the patient! 26

Ill-Health affects the Individual’s

Performance - at the place of work.

Organization - absence, loss of man-hours, substitution,

work disruption, medical reimbursement etc.

Family’s - finances and its happiness.

Financial - savings get drained and children's careers

are affected particularly due to Diabetes M,

Hypertension and related complications,

Brain & Cardiac surgeries, Renal & Liver

failure and transplant cases, treatment of

Cancer.

Impact of ill-health…...

27

A reasonable Health

&

A right Mental attitude

are

mandatory

to

lead a Stress free Life.

Balance between Body & Mind...

28

Health is an individual’s responsibility

Dr. Bapuji Balijepalli

Health- an Individual’s responsibility…...

29

Staying reasonably healthy, is every individual’s sole responsibility. This has to be borne in mind by everyone.

Quality of one’s Health after the age of 60 solely depends on the lifestyle the individual had led from the age of 20.

“Man runs after Money till the age of 40 and loses his Health; and then runs after corporate hospitals losing everything he has earned, but fails to regain Health.”

Biological Ageing

Ref: Geriatric Medicine - “Current Medical diagnosis and treatment”, 43rd edition

Biological ageing…...

30

Human biological ageing is best characterized

as the progressive constriction of each organ

system’s homeostatic reserve (ability of each organ to

function optimally, even during all situations that cause

functional disruptions).

Gradual decline of this ability of the body, begins

after the age of 50, and is progressive and varies

from one individual to another.

This decline of each organ is influenced by one’s

Genetic and Hereditary factors, Diet, Environment

and personal Habits.

Life span improvement- Impact

Total Annual Medicare expenditure of USA used to be only $ 8-10 Billions per annum in 60s.

United States of America spent more than $1,900 billion in the year 2005 (15.3% of GDP), which is projected to increase steeply in future touching $ 2.9 trillions in the year 2009 and by 2015 it is likely to reach $ 4 trillions.

Ref: National Coalition on Health Care - Health Insurance Costs,

facts on the cost of Health Care, web: www.nchc.org

Economics of Health…...

31

The average Life Span in most developed Countries has gone up to almost 80 years.

If people live so long without reasonably maintained good Health, they tend to become a burden on the economy of even the most developed country such as the USA.

?

Health care spending in USA….

Effects of high Health care costs in USA……

32

Health care spending in USA is 4.3 times of

what is spent on the country’s National

defense.

It is given to understand that 25% of total

Annual Medical Budget is spent on the last

one year care of the elderly Americans

above the age of 80.

In USA 47 million people are not

covered by insurance even today !

The number is going to increase

as the insurance premium is likely to

rise to unaffordable levels.

According to National Coalition on Health care, USA

A recent study by Harvard University researchers

found that:

Average out-of-pocket medical debt of those who filed for

bankruptcy is $12000.

68% of those who filed for bankruptcy had Health insurance.

50% of all bankruptcy filings were partly the result of

medical expenses.

Every 30 seconds in the USA, someone files for bankruptcy

as an aftermath of a serious health problem.

Health Insurance Costs

Ref: “Health Insurance costs” Facts on the cost of Health Care- www.nchc.org


33

http://www.nchc.org/

Economic constraints of Developing countries

Budget 2011-2012 (Health Sector): `267.6 billion ($ 51.80 Billion)

The current allocation for health sector in the 2011-12 Budget is 0.29 of GDP.

All States Budget (2011-2012): 4.2% of aggregate expenditure : 0.7% of GDP.

All States spent on Health Care is ` 718.344 Billion ($144.8 Billion)

(Reverse calculated based on the GDP. Correct Figure not found on Internet)

Total Indian Healthcare sector- $ 51.8 + 144.8 = $196.6 (Govt. sector)

$150 (Private sector approx.)

Comparative 2012- Total healthcare Budget

INDIA 2012- $ 246.6 for 1.2 Billion people Billion.

USA- $ 3 Trillion for 300 million people


34

http://articles.timesofindia.indiatimes.com/2011-03-03/india/28650551_1_allocation-

health-care-delivery-system-nrhm

One can imagine What would be the state of other developing Countries!

Indian Health Statistics

http://articles.timesofindia.indiatimes.com/2011-03-03/india/28650551_1_allocation-health-care-delivery-system-nrhm

















NOBODY FUNDS FOR CHRONIC DISEASES

Funds are provided only for AIDS, Cancer, Swine Flu, Dengue Fever, Japanese Encephalitis, Stem cell research, Cloning, retarding Ageing etc. in Developed countries.

Ventricular assisted device for a young man of 25 years for 2 years in a dilated Cardiomyopathy case, costs $ 1-2 million, until a Heart transplant is done which would cost an additional $ 1 million in USA where 47 million + people are still not covered by Insurance.

As far as research is concerned in developing countries, it is only a dream due to paucity of Funds and Policy makers’ short sightedness and their priorities are entirely different.

Meanwhile Increase in the incidence of Chronic diseases is taking the toll of people and the economy of countries including that of Developed ones.

Chronic diseases…...

35

Chronic diseases can cause loss of Billions of Dollars

According to a WHO report:

“India alone is estimated to have lost in 2005 – 06, $ 9 Billion

in National income from premature deaths due to illnesses like:

Heart disease, Strokes, Diabetes and Cancer.

In next 10 years, the estimated accumulated losses due to above

diseases in the following countries would be:

If preventive measures are not taken by proper investment and planning, 36 million people would be dead prematurely by 2015.

- China $ 558 Billions

- Russian Federation $ 303 Billions &

- India $ 236 Billions

Ref: “Health” Sunday supplement Deccan Chronicle, 16th Oct. 2005


36

Why is this situation ?

1. Not enough emphasis is given to the management of Chronic illnesses either by World Health Organization or the Governments of Developed and Developing Countries.

This is because the results are not perceived immediately.

2. Governments are ignorant of the fact that educating and motivating people on mere Dietary discipline, Regular exercise to suit the age and health status of the individuals and Life Style changes will go a long way in improving the quality of Life.

3. It can save Billions of Dollars even for the most developed Countries who are struggling to cope with the increase in the Life span of their population.


37

Population Ageing…

Population ageing is going to outpace Social and Economic development.

Population ageing is humanity's greatest triumph and also the greatest challenge.

Developing countries will become old before they become rich and,

Developed countries became rich while they were growing old.

Ref: WHO - “Towards Age-Friendly Primary Health Care”, Geneva, 2004.

Population ageing…….

38

http://www.harrycutting.com/photos_people/elderly-pictures-493-K147-23.htm

580 million older people in the world today, 60%

in developing countries.

2020 the number will rise to 1000 million and 70% of them will be in developing countries.

People over 80 constitute 1% world’s population and 3% of the population of developed countries.

This group of 80 year old is the fastest growing sequel of older population.

Population of Elders…

India has the 2nd largest population of elderly

(76 million in 2001). It will touch 137 millions in 2021.

Ref: WHO – “Ageing Exploding the Myths”, Geneva, 1999


39

Can Economic prosperity of a country take

care of all its Elders ?

No country however prosperous, can take care of

her entire elderly population.

What happens to lesser mortals in developing

countries, where safe drinking water, nutrition to

children, basic Medicare, control and eradication

of infectious diseases is still a dream?


40

Not having High blood pressure, Diabetes or Heart problem, are not the criteria at all after the age of 60. They are bound to develop with the ageing depending on one’s family history and the life style one has led.

If one is able to sleep well, able to have a

good satisfactory bowel movement once in a day, able to relish food & digest, able to take care of one’s day to day needs by oneself, commute on one’s own and not become irritable for trivial reasons, then…

Criteria for reasonable Health of Elders…

One is considered as reasonably Healthy.

Criteria of Health for Elders…….

41

“A 70 year old man was traveling along with his 40 year old son, 33 year old daughter-in-law and 7 year old grandson in a boat.

The boat suddenly started sinking a few meters away from the bank of the river. There was a young man sitting with a fishing line on the river bank who saw this incident.

He spontaneously jumped into the river to rescue these people. He first tried to save the 7 year old boy. Even the old man was concerned about the grandson’s safety first at his cost; while the son was busy saving his wife.

This was a natural spontaneous and justified reaction anybody would have had in the situation.”

Story of a 70 year old Man…

Story of 70 year old…….

42

The moral of the story is that-

1. Older people have the last priority in this world even for survival.

2. Older people have to help themselves and adjust.

Otherwise even kith & kin will not be

able to help, leave aside the society or the State.

Old people - last priority

Moral of the story…….

43

http://www.harrycutting.com/photos_people/elderly-pictures-147-K133-31.htm

It is not the Life expectancy / Span that

counts, It is the Quality of Health of the

population that is important.

What is Important?

Life Expectancy/Quality…….

Is it Life expectancy or quality Life?

44

Impact of Ill-Health

Ill-Health affects an individual and his/her Performance, it

affects the Family, its Happiness and its Finances.

The impact of Salary earner's Ill-Health could be so severe

as to drain away all the financial savings of the family, affect

the future Career of his Children and Domestic relationship.

Impact of ill-health…….

45

Impact of Ill-Health

Impact of ill-health…….

46

A Chronic invalid, bedridden member of the Family may make so many demands on the time, energy and finances of the family that may have serious constraints in coping with the situation.

A Child's sickness could result in severe trauma on the whole family, ultimately influencing its entire life style.

“To live is not sufficient. we need also the Joy of Living; and the Joy of Life requires Health. Above all, we need the Health which embraces the Body, the Mind & the Soul."

Alexis Carrel 1873-1941

Doctor & a Nobel Laureate (1912)

Joy of Life…….

47

KIDNEY - Each kidney has 1 Million filters.

LIVER - Even One-tenth

of Liver can meet body's

every day requirements.

WBC - 126 Billion cells (each with a Life span of

only 9 - 12 days) constantly circulating throughout

the body, protecting us from infections.

EAR -can differentiate 1600 Frequencies.

Bladder

Urethra URINARY SYSTEM

One Filter (Nephron)

Kidney

Ureters

HUMAN BODY - a highly complicated structure

48

Complexity of Human body…

*Science can never ever surpass, achieve or at least match what Nature/God has created.

Human Nervous System functions with about –

50 Billion nerve cells (Neurons),

10 million input fibers &

½ a million output fibers

Airspaces in both the lungs, if spread on a

plain surface, can cover one Tennis court.

Total length of the blood vessels and lymph

vessels in an adult Human body can run up to

60,000 Miles.

Complexity of Human body cont’d…

Neuron

49

HEART (The size is just that

of a fist in adult)

In Adults, has 60 miles length of

blood vessels.

In a 70 year life span of a man,

Heart pumps 250,000 gallons

(1 million Liters) of Blood.

May have beaten 3.5 billion times.

Complexity of Human body cont’d…

50

Criteria for Diagnosing Coronary Artery Disease

RISK FACTORS Patient is above 30-35. He is Obese and Sedentary life Has Diabetes or High Blood Pressure or both mostly uncontrolled. He is a smoker. Abnormal Cholesterol levels. Patient has Family history of CAD - (Grand parents, parents and their siblings, his own Siblings) of Diabetes, Hypertension & Coronary Artery Disease.

Family history of sudden deaths in young, middle aged or below 65.

TESTS SHOW ABNORMALITIES If tests show abnormality like in resting ECG or TMT (not to be done for risky patients above 60-65 who can develop Heart attack during or after TMT). 64 slices CT Angiogram also can be done. These tests are not fool proof and are not confirmatory.

II CLASSICAL ANGINA - Mid sternal pain (behind the chest bone). Griping or Squeezing type, Choking feeling, radiating to left side of the neck or left angle of the jaw or inner aspect of left arm to little and ring finger. Usually, the pain precipitates by Physical exertion, Sexual intercourse or on hearing shocking news. Diagnosis of Unstable Angina has to be supported by definitive changes in ECG. III

I

51

Criteria Coronary Artery Disease- Intervention…..

• Coronary Angiography is the only definitive test to confirm CAD which

has to be followed by Stress Thallium test to reconfirm the decreased

Myocardial perfusion (blood distribution in the heart muscle) which should

tally with the area of blocked or narrowed artery shown earlier in

angiography. Where TMT can not be done or patient is not prepared or fit

for Angiography, Dobutamine Stress Test or Adenosine Stress Test can be

done except in a case of impending Heart attack or Acute Heart attack.

*Then only, a decision for PTCA & Stent insertion or Bypass surgery

should be taken based on the age and the other criteria of Patient’s health.

But, If hospitals are doing PTCA with Stenting, just based on any type

of chest pain or any vague discomfort above the “belly button” with

insignificant changes in ECG, nonspecific T “wave” inversion or ST

segment depression < 2 mm, is totally absurd. It is not at all justified to

force the patient, inducing fear to go through PTCA and stenting at night

where Patient cannot even have the scope of second opinion.

52

• In equivocal cases (doubtful cases) of Heart attack or an impending Heart attack from the Physician’s point of view, the patient can be given Sedation, Coronary vasodilators, Antiplatelet medication immediately & Thrombolytic therapy, after shifting to a Hospital to monitor the case in a Coronary care unit. This is what the most acclaimed Cardiologists have taught and even today it holds good.

• There is nothing that the patient or relatives can do except

praying, to prevail upon the “Conscience” of the treating Cardiologist.

Criteria for Coronary Artery Disease- Intervention…..

• Unfortunately, after the advent of Angioplasty (1982), “bare metal Stent” (1992) & Medicated Stent (DES- Drug eluting Stent) in 2003-2004, approach to treat the patient has been “highly tainted” in Cardiology. Greed has taken over the rational and ethical approach.

• In a case of Heart Attack, First half an hour is known as the Golden period, where the Physician who sees the patient first, should be able to give the 3 of the 4 drugs mentioned above, immediately prior to shifting the patient to CCU or even before the Cardiologist arrives.

53

Coronary artery disease and By-pass graft (CABG)

Aorta

Circumflex artery

Anterior descending

CABG Venous Graft

1st Septal

Right coronary Artery

Left Coronary Artery

Posterior Descending

Left Mammary

Venous grafts get closed within a few months to 6 years period. Arterial graft of left

Mammary artery can last up to 20 - 25 years. There is no difference between Venous

graft and Radial artery graft as far as prognosis is concerned.

54

120 mm

of Hg

10 mm

of Hg

Cross section of an artery of the Heart.

Cross section of Saphenous Vein from the Leg used as Venous graft.

Gross difference in the caliber of Blood vessels in the heart & those that are used in CABG

Limitation of CABG cont’d…..

55

Fat gets back to where it was in 30% of the cases, on the same day and in rest of the 70% cases, within 6 months.

Balloon Angioplasty (invented in 1982 by a French Doctor) (PTCA-Percutaneous Transluminal Coronary Angioplasty) - diagrammatic

Tunica External (External layer)

Tunica Media (Middle

Muscular layer) Tunica Intima

(Endothelial Layer)

Balloon deflated & withdrawn within 120 Seconds

Atheromatous Plaque (Fatty bump)

56

Balloon Angioplasty

(PTCA-Percutaneous transluminal Coronary Angioplasty)

Introducing a Catheter from the femoral artery in the Right thigh up to the Coronary artery that is blocked, in the Heart (visualizing on a

monitor) and sliding a balloon on it.

Angioplasty procedure cont’d…..

57

Normal Coronary artery Narrowed Coronary artery

Catheter being passed

Balloon passed along

the Catheter

Catheter

Catheter

Inflating the balloon to press the fatty bump for not more than 2 minutes. Otherwise that

itself can cause Heart attack.


58

Balloon fully inflated to

widen the narrowed artery.

Balloon withdrawn and

the narrowness gets

back.

Hence, a Stent is glided

on the Balloon.


Stent

Balloon Angioplasty and inserting a STENT

Balloon has to be withdrawn within 2 minutes after placing the Stent to avoid heart attack.


59

Balloon is deflated to

withdraw, leaving the Stent

in place to keep narrowed

blood vessel widened.

Stent remains in place

after Balloon and

Catheter withdrawn.

Stent in

place


Balloon is being

inflated to expand the

Stent.

Strategy of Cardiologist

to hurry up the patient for taking a decision for

PTCA and Stent as against CABG

CABG

PTCA DES Stent

Bait for PTCA & Stent…

• Chest need not be cut open.

• No heart lung machine.

• Heart need not be stopped for an hour or two.

• No wiring for the chest bone.

• In two days Patient can be back to his normal routine and duties.

• No lay off to the patient for 2 - 3 months from normal activity.

60

Problems with the Stent

1. Once placed at the right or wrong position in the coronary artery, it cannot be retrieved or moved to the required spot.

2. It is an obstruction to smooth flow of Blood. Hence the person has to take anticoagulants daily for life long, with weekly and then monthly blood tests.

3. Since it is a foreign body to the inner lining of the blood vessel, the lining reacts and the cells multiply and engulf the Stent and eventually cause total closure of the whole segment of the blood vessel within 6 months. It then becomes mandatory for the patient to go through CABG.

4. PTCA and insertion of Stent is useful only in (i) acute Myocardial infarction to limit the damage (ii) Young patient < 35 & (iii) very elderly who cannot endure CABG operation i.e. Complicated case with serious other diseases that can lead to Anesthetic, Intra-Operative or Post-Operative complications.

“Stent” has a limited use, but most misused

54

Two types of Stents- Bare metal & Medicated Stent (DES) available today

61

Stent has limited use…

4. The drug-coated Stents (Drug eluting Stent- DES) were invented in 2003, to solve the problem of restenosis encountered in bare metal stent (closure of the blood vessel) with a drug Rapamycin and a polymer coating on the Stent, and they do that very effectively. But now, new analyses of data presented in clinical trials performed by Stent makers are convincing some researchers that the drug-coated Stents are more likely to cause blood clots at the stent site, which in turn could lead to Heart attacks.

Sudden deaths have been reported in people who have received these DES

stents. During the first 2-3 years since 2003, Hearts from all over the world

removed from the dead who had drug eluting Stent were pouring in to

Dr. Renu Virmani’s Laboratory in Maryland. (a Non-profitmaking organization).

Drug eluting Stent….

62

Drug eluting Stent cont’d…

In seven years since they were introduced, DES have become one of the world's most widely implanted medical devices. They are also highly profitable, generating about $ 5 billion a year for their manufacturers and building Boston Scientific Corp. of Natick into the most valuable life-science company in New England, USA. Though often fatal, clotting inside Stents is also so common these days that it was barely registered in initial clinical trial statistics conducted within 2-3 year period since 2003. *But, as on today, restenosis and fatal heart attacks due to clot formation are more frequent within 4 years after DES insertion.

"What we see is there is a delayed healing from all these drugs," she said. "You created a wound in an artery wall. Now you have put in a drug that doesn't allow the wound to heal. You're going to have a problem.” Renu Virmani, MD, Medical Director of Cardio-vascular Pathology Institute, Inc., in Gaithersburg, Maryland, USA. [email protected]

"Are we trading a Benign problem for a Malignant one ?" asks Steven Nissen, Chairman of Cardiology at the Cleveland Clinic. 63

http://boston.stockgroup.com/sn_overview.asp?symbol=BSX











The Modus Operandi as narrated by Patients is -“You are lucky that you have reached hospital in time, Had you been 15 minutes late you would not have been alive.” “If you move, your heart may stop”. If son takes his father, “You can take him but if he has a fatal attack, we are not responsible”. If Patient is taken away from ER, It is recorded in the case sheet as “LAMA” (left against medical advice). This can make any body susceptible at the middle of night.

CABG (By-pass surgery) seems to be the only and safe option. If a Stent is opted, the criteria given on slide/page 59, point 4 to be taken into consideration.

Is the Patient given these details prior to PTCA and insertion of Medicated stent? Patient is not given a chance for second opinion at all, and most of the time it is not possible particularly at night in ER.

64


Precarious situation in people who receive DES ( Medicated Stent )

• Another serious implication in patient who receives DES (Drug eluting Stent or Medicated Stent) is that he has to be put on anti-clotting medication- Clopidogrel 75 mg + Aspirin 75 mg, every day after lunch for Life long. Even for tooth extraction he would be unfit as the bleeding will not stop. If medicine to prevent clotting is stopped even for 2-3 days to facilitate surgery, clot will form at the Stent site and it can cause a fatal heart attack!

• Dental professionals, ENT Surgeons & Ophthalmologists have to verify this before taking up the case.

• Meanwhile, God forbid, if an emergency surgery is required for this Patient, Anesthetist would refuse to take up this case, as the patient would bleed profusely on the operation table when taken up.

“Catch 22 situation”!

May God save the Patients! 65


Even those who are on only Aspirin 75 mg per day, have to stop 5-7 days

before, even for a minor surgical procedure like Dentist’s intervention.

• I am given to understand that the Cardiologists are known in USA as Gate-keepers. Means, first grabbers of the Patients, as soon as they arrive at ER (Emergency room) with any discomfort above the “belly button”. In India it is still worse.

• Do you know that these interventional procedures are not without complications? While passing the Catheter from the artery (Femoral) in the groin to Heart, tearing / dissecting of inner lining of major arteries, Aorta, and the Coronary arteries and the torn flap can suddenly block the whole coronary artery, are common complications and sometimes fatal too. In the worst hands, rarely, coronary artery can rupture.

• After successful placing of Stent, the consequences are –total

occlusion of all the smaller branches of Coronary artery at and beyond the Stent site, due to non-progression of pulse wave from Heart to the blood vessel, resulting in slowing of blood flow. If multiple Stents are placed (4 to 5), substantial portion of Heart muscle gets damaged due to lack of oxygen & nourishment. By-pass surgery later, can not restore the Cardiac muscle functioning, as the damage is irreversible. (as shown in the next Page/Slide. The pumping capacity of Heart declines critically.

66


IMPLICATIONS OF STENT INSERTION

Healthy small branches

of Coronary blood

vessels.

Pulse wave from

Heart beat

All small Blood

vessels get

blocked due

to slow blood

flow- No

pulse wave.

DAMAGE- Aneurism, reduction of

LVEF, Dilated Cardiomyopathy if

4-5 Stents are inserted. By-Pass

surgery also can not restore

normalcy of Heart. Patient can

not have normal basic physical

exertion and has to be off SALT

totally for rest of his life.

* Slowing of blood flow distal to

Stent causes all the small

vessels to get blocked resulting

in the Heart muscle to thin out

and pumping capacity drastically

decreases from these areas.

* Pulse wave from Heart to

the Coronary artery stops at

and beyond the Stent.

* Stent leaves a raw area in the

inner lining of Blood vessel due

to movement of Stent to & fro

during each pulse wave. At this

rough site Clot can form if anti-

clotting medication is missed for

few days & cause Fatal Heart

attack.

SEQUENCE OF EVENTS AFTER

STENT IS INSERTED LEADING TO

MYOCARDIAL DAMAGE TO HEART

Stents in situ

67


ARE INDIANS SO DISPENSABLE FOR

CLINICAL TRIALS OF SOME DRUGS ?

In Coronary artery disease - Clopidogrel 75mg + Aspirin 75mg is prescribed in patients who have received Medicated (DES) Stents to prevent death due to Clot formation at the sent site. This drug combination is prescribed once a day after food. Of late, this combination drug is being prescribed Twice a day, by some Cardiologists! Some companies are manufacturing the above drugs with Cholesterol reducing medicine (Statins) in a single tablet to be taken at bed time ! Will it not cause Esophagitis and Gastritis and bleeding from the Stomach, as it will be empty at bed time? It can also cause retrosternal pain, which will mimic Angina due to Esophagitis.

In India, past 2 to 3 years Clopidogrel 75mg + Aspirin 75mg is being prescribed, as prophylaxis even for patients who have not received Stent, which is Outrageous. Nowhere it is mentioned in the standard medical text books.

Indian Patients, including Educated ones, are totally unaware of these things! 68

Drug trial in India…

It seems to be an Unethical clinical trial on Indian Patients. Are Indians Guinea pigs or so dispensable? There seems to be no value for life in India !

BIO-DEGRADABLE MAGNESIUM STENT (BDM-Stent)

•Researchers from West German Heart Center, Essen, announced in June 2 issue of Lancet 2006, successfully implanted 71 BDM Stents in 63 patients. After a year, there were no problems and average diameter of the blood vessel increased by an average of 1.41 mm where this BDM stent was put. Patients did not require clot dissolving medication such as Clopidogrel + Aspirin.

•This technology will do away with the “Dr Jekyll and Mr. Hyde effect of DES Stent” said Dr. Deepak Natarajan, an interventional Cardiologist.

•However according to former Chief of Cardiology AIIMS, Delhi, India, Dr K Srinath Reddy, whether “Stents really alter the outcome and prevent Heart attack and improve Life expectancy, is still being debated”.

•“Some studies say that there may not be greater benefits from placement of Stents in comparison to Medical therapy except in few cases of acute Heart attack.

Ref: Published on Page 12 The Times of India Hyderabad ,Sat June 2nd 2007

BDM Stent…

69

It is the deposition of Fat beneath the inner layer of the blood vessel that has to be arrested and whatever is deposited has to be reversed.

CABG & Angioplasty cont’d…..

Angioplasty and CABG are palliative which are only temporary solutions to overcome a centimeter or a few centimeters of obstructions. They should be taken up judiciously where the blocks can be fatal if not attended to. As on today CABG seems to be a better option than PTCA.

CABG/ PTCA…

70

It is the question of Health of 60 miles length of blood vessels.

How can there be a Mechanical solution by putting a Stent for a Metabolic disorder ?!

60 miles

Stent

Mechanical solution?…

71

Strict changes in Diet and Lifestyle, not only prevent Heart

attacks but can actually reverse the clogging of arteries,

according to a small but pioneering study reported in late 80’s

in California, USA.

Life style can save heart…

72

Lifestyle shift can unclog Arteries

The Study showed that a Vegetarian Diet, Moderate Exercise

and an hour a day of Yoga and Meditation could produce

reversal of Atherosclerosis (Blocks in the blood vessels).

Study conducted by:

DR. DEAN ORNISH Director of Preventive Medicine & Research Institute, Sausalite, California, USA.

Atheromatous

Plaque


73

Inter-connected three tank Phenomenon

(To understand how Diet, Reduction of excess Weight, Exercise and Medication when needed can reduce the fatty blocks in the

blood vessels)

Level Level Level


74

“Medical teachers know that half of

what they teach is untrue - the trouble

is that they don't know which half !"

Attributed to:

Dr. C.S. Burwell

(formerly DEAN, Harvard Medical School)

From the opening page of a book:

"CARDIOLOGY" 4th Edition

by

DESMOND G. JULIAN MA, MD, FRCP, FRCP(E), FRACP

1+1=3

Limitations of Medical field…

75

Health is not a commodity that can be purchased either in

a Specialist's clinic, or in a Pharmacist's shop, or even in a

reputed Hospital.

You can acquire it only by your

own efforts.

Remember,

It is not just sufficient to acquire Health, it has to be maintained

through continuous efforts as long as one lives.

76

Commercialization of Medical field…

First Consultation ( should be in writing )

1. List of Present Complaints, chronologically oldest to latest,

2. Relevant past history,

3. Family History,

4. Personal History - Diet, Routine, Bowel habit, Sleep, Type of work,

Habits and Addictions, periods, Menopause etc.,

5. Clinical Examination and Provisional Diagnosis, 6. Lab Investigations taking into account the previous Tests,

so that Final Diagnosis is arrived at, with minimum tests to reduce the costs and the ordeal to which the patient is subjected to.

7. Final Diagnosis.

8. Prescription & Opinion : i) Clear Instructions about Medication & Diet expected side effects, How long? and why etc.,

ii) If Surgery needed- Why? How Soon? Who is the Best Surgeon? Costs etc.

iii) Referrals to appropriate Specialist, if needed.

Approach to a Patient…

77 Hence, many misses in Diagnosis, impending complication and wrong treatment!

The above method of examining the Patient is a century old, taught to us by the British, which is

fool proof and Cost effective, even today.

Today, tests are done first even before doctor examines the Patient ! Only to serve the High cost Medicare

and Doctors of course. Approach today is- To see many Number of Patients in a day and collections are

important! In India some Specialists see 60-100 patients a day in Cities. Appointment has to be taken

1 to 3 months in advance, to see some Specialists in India. Patients are also to be blamed here.

Is it not marketing oneself ?

Until three decades ago, a Doctor enjoyed this status:

But today, the commercialization in the various systems of

medicine and unethical approach pushed the unique status to:

The situation will only

worsen in future.

You are the brother of God of Death.

Whereas the Doctor takes away the Life, as well as Money.”

The God of Death takes away the Life of the person;

“Doctor is compared to God”

“Oh Doctor, I salute you; ?

78


Medicine and Commercial Interests often

make a very Unhealthy combination

The approach of Medical scientists, sometimes, seems

primarily interested in extending Medicine's Technical

prowess, with scant regard to Ends and Values !

$

79


-like all sorts of consumerism, only more menacingly designed to be unsatisfying.

Medical Consumerism

The prolongation of life and search for

Perfect Health (Beauty, Youth & Happiness)

are inherently self-defeating.

The law of “Diminishing returns”

necessarily applies.

80


Vaccination - for Small pox, Rabies, Polio, Measles, Mumps, Tetanus, DPT, Hepatitis B

Anaesthetic - techniques- Local, regional, epidural, Spinal, General etc.

Antibiotics - Anti-tuberculosis, Leprosy, Penicillin, Septicemia,

for serious infections.

Diagnostic techniques- Digital X-ray, Ultrasound, Echocardiography, CT Scan,

CT angiography, MRI, MRI angiography, Doppler study of blood flow, Laparoscopy,

Fiber-optic Endoscopies, ERCP, PET Scan, Trans esophageal Echo. Cystoscopic

approach in renal conditions.

Surgical Procedures- External & Internal Pacemakers, Pacemakers with defibrillator,

Robotic surgery, CABG, Heart valve replacements with non-metallic valves, Cardiac &

Lung transplants, Ventricular assisted device, Key hole surgeries, Kidney& Liver

transplants, Lithotripsy for stones, Hip and Knee replacements, Spinal surgeries,

Surgical Oncology, Linear Accelerator for therapeutic radiation. Interventional

Radiology, Lasik for Myopia. Fiber-optic approach in ENT surgeries, Tympanoplasty,

Stepidectomy, Hearing aids etc.

Dental: Implantalogy- Supported Dentures or Fixed teeth, Reconstructive

Surgeries.

IOL: for Cataract with foldable lenses & Lasik for refractive errors.

Plastic Surgeries: Cosmetic surgeries and many other achievements.

Marvelous Achievements of Modern Medicine

81

Last Century has seen the greatest triumphs of Medical science, but paradoxically, now more than any time in the past three Centuries, the Medical Profession doubts itself.

Yet, as these expectations grow unlimited, they become difficult / impossible to fulfill.

The task facing Medicine in Twenty-first Century will be to redefine its limits even as it extends its capabilities.

Medical field has led people to vastly inflated expectations, which the public has eagerly swallowed.

Modern Medicine’s achievements,

Over expectations of Patients…….

82 There are still dozens of diseases even today where Modern medicine has no answers.

For all Medicine’s success stories, who would

deny a certain Malaise ?

The Atmosphere is one of hollow conquest as at

the end of many a hegemonic battle fought in the

past few decades.


83

The Efficiency of a Physician lies in his Clinical skills,

ability of differential Diagnosis, arriving at the final

Diagnosis with minimum laboratory investigations.

An efficient Doctor writes minimum number of Medicines, which are less expensive and have the least side effects.

He deals with the patient with concern and compassion.

He does not hesitate to accept his ignorance at times and

does not mind to refer to a good Specialist or check with

a Senior colleague about the patient’s problem.

QUALITIES OF AN EFFICIENT PHYSICIAN

Physician’s qualities…

84

In the words of Hippocrates,

the father of Modern Medicine:

“Cure rarely,

Comfort mostly,

Console always”


85

If a Doctor practices sincerely with a

little concern and compassion for the

patient, there is no dearth of Money

and there would not be so many law

suits against Medical Professionals.

The amount of job satisfaction a

sincere & compassionate Doctor

gets, no other profession can provide.


Sincere Doctor- No dearth of Money & Job satisfaction

86

Doctor - Patient Rapport

If a Patient does not trust the Doctor and the Doctor does not trust the Patient, how can the results be achieved even from the best treatment, particularly in day to day ailments & in Chronic Diseases ?

This is exactly what is happening in the West and same thing has crept into Indian Cities these days.

The way it is practiced, mostly is the “Defensive Medicine”, which is neither in the interest of the patient nor the economy of any country.


87

How ignorant today's educated Patient is and

how difficult it is, sometimes, to handle him,

Do you know ?

Please try to answer the following Questions.

Ignorance of Educated…

88

What is the Normal

Blood pressure for adults?


89

Normal Blood Pressure (in adults)

100 / 60 to 140 / 90 mm of Hg. for people below 50 years of age.

100 / 60 to 160 / 90 mm of Hg.

for people after the age of 50 yrs.

Normal range of Blood Pressure: 100<140 (Systolic)

60<90 (Diastolic)

120 / 80 and Age + 100 etc., as presumed by people, are not correct.

The Blood Pressure is never constant throughout the day.

Self measuring BP gadgets are not in the interest of Patients.

No Chronic disease by name low Blood Pressure, as believed by educated people, is existent in Medical annals.

90


SIMILARLY,

Pulse Rate

It is not constant at 72 / min as presumed by people.

Normal Pulse rate is – 60 to 90 beats / min.

Do you know that some people have MISSED BEATS, which is quite a common phenomenon particularly in smokers & those who consume lot of Tea & Coffee. It is quite normal to have 4 to 6 missed beats/min and do not cause any problems.

Normal temperature – 98.4° F + 1

It is never constant at 98.4° F as presumed.

91


Sugar levels

Blood Sugar level in Normal People & Diabetics

more than

200

above 140

but

below 200

less than

140

Sugar levels

after

2 hours

200 at

least once

less than

200

less than

200

Sugar level

from

0- 2 hours

more

than 126

110-126

less than

110

Blood sugar

Fasting

Diabetic Potential

Diabetic

Normal

Person When there is a doubt whether a person has Diabetes or not, Glucose tolerance is the best test. The person has to give Fasting (12-14 hours from the

previous night’s dinner) blood sample in the morning and then he is given 75 grams of plain glucose. Samples are drawn every half an hour for blood glucose estimation (4 samples apart from fasting sample).

0

hours

2

hours

Time

Ref: Current Medical Diagnosis year 2000 edition


92

Should you walk as an exercise after Dinner ?

The answer is --

SIMILARLY,

No Bath immediately after Food intake.

You have to wait at least for 2 hours.

No.

93


Are you supposed to use a Pillow under the Head ?

Sleeping on the back with a thick pillow to watch

TV or to read is very bad for the neck.

Sleeping on the back with a thin pillow or without a pillow, is

correct. But it is impractical .

If you do not know how to use a Pillow correctly, which is a daily affair, you are heading for serious symptoms of Cervical Spondylosis, which can create confusion with Cardiac pain.

Sleeping posture…

94

The only practical and the correct way of sleeping and using a Pillow is-

*Throughout during sleep, one changes position from right to left and left to right more than half a dozen times.

Pillow should be sufficiently & effectively thick (when soft pillow is used) to keep the neck horizontal. Always sleep on the side.

*Sleeping on the stomach is not at all good for the neck from the age of adolescence onwards.

Sleeping posture…

NOTE: Mattress should be 1 to 2 inches thick (Cotton) and on hard surface, for sleeping.

95

The correct aspects of Cholesterol levels

For example: 150 / 15 = 10 : 1 Unsafe | 260 / 80 = 3.2 : 1 Safe

or less

Normal Lipid Profile Total Cholesterol - 160 - 200 mg/dl (HDL+LDL+VLDL)

H D L - 45 - 80 mg/dl (Higher The Better)

L D L - 130 mg /dl or Less VLDL - 27 mg / dl or Less TRIGLYCERIDES - 145 mg / dl or Less

Total Cholesterol = 4.5 : 1

H D L

96

Lipid profile…

This Ratio is Most

important

VLDL & 1/5 of Triglycerides are converted to LDL which tend to get deposited in the blood vessel causing blocks.

HDL removes fat from these blocks into the blood.

If deposits are more and withdrawals are less, blocks develop.

If withdrawals are more and deposits are less, blood vessels are healthy.

Fatty blocks in the Blood vessels Various components of Lipid profile & their relationship

LDL VLDL

HDL

1/5 of total

Triglycerides

Fat Deposition Fat withdrawal

Total. Cholesterol

HDL

This ratio is vital

4.5

Cholesterol cont’d…

97

To improve HDL levels in the Blood (High Density Lipoprotein, “good component”, “vacuum cleaner” in the blood vessels)

1. Your Diet should contain more amount of Vegetable fiber. (Skin- of some fruits, Green & Leafy vegetables).

2. Physical Exercise “25 minutes Yoga for You” refer pages 220 to 223 or any other strenuous exercise for 45 minutes everyday.

There are No Medicines to improve HDL levels in the blood.

But, there are four methods to improve it.


98

3. Moderate quantity of Alcohol promotes HDL levels.

What is moderate? (page/Slide-238)

To improve HDL levels in the blood…

4. Prerogative of female gender. Female hormones

before menopause, protect Women from Heart

attacks 10 times more compared to men. During

menstrual cycles, the female hormones naturally

keep the HDL levels high in a woman.

“A Lady can never have a Heart

attack before menopause but can

cause many heart attacks”!


99 “Ladies may take it as a Compliment Please”

The good Cholesterol hypothesis comes from studies like the

Framingham Heart Study that followed thousands of people

for years to see who developed heart disease.

The study showed that if two people had the same levels of the

bad Cholesterol (LDL), but different levels of the good

Cholesterol (HDL), the one with more HDL was less likely to

have heart disease.

Researchers examined the biochemistry of the two molecules

and learned that they have opposite roles.

Framingham Heart Study


Low Cholesterol is also not good for Health

1. Cancer

2. Liver damage

3. Respiratory diseases

4. Injuries

5. Accidents prone

Low Cholesterol (less than 160 mg/dl) levels are associated

with an increased risk of mortality from other causes like:

A statistical study report published in JAMA (Journal of American Medical Association)

NOTE: Cholesterol is an important raw material for Cell membrane and

Nerve insulation repair, production of hormones like

Adrenal and Sex hormones.


Triglycerides

Since 1/5 of Triglycerides are converted to LDL (bad constituent),

which is one of the contributors of Total Cholesterol levels,

If one can maintain

Total Cholesterol / HDL ratio to less than 4.5, one need not

worry about Triglycerides if the levels are below 500 mg / dl.

However, to reduce Triglycerides in the blood,

Remember

One has to cut down on CARBOHYDRATE intake in Diet

i.e. Rice, Tubers, Sugar, Sweets, Desserts & Alcohol


102

Raw Foods (which provide fiber in Diet)

SALADS FRUITS (except grapes)

Cucumber Banana, Apple, Oranges

Carrot Sweet lime, Guava,

Tomato Pineapple, Sapota,

Beetroot Papaya, Watermelon,

Radish Muskmelon, Jackfruit,

Tender Cabbage Custard apple etc.,

Capsicum

Onions DRY FRUITS

Soaked groundnut (12 hrs.) - Almonds

Sprouts (24 hrs.) - Cashew

Coconut (raw) - Dates

- Pistachio

- Raisins


103

Note: One of the three meals(means anything solid eaten in the day) should be of Fruits and Salads.

Physical Mental

Health Health

lowered

1. Ignorance of Moral

Drop in the and Ethical values

threshold to 2. Lack of Professional and

face a given Domestic Commitment

Problem 3. Lack of Contentment

4. Lack of Positive attitude

5. Ego

Health

Stress

104

Mental Health depends on....

1. Moral and Ethical values as far as our Conduct at Home, at Work place and in Social circles is concerned.

2. Professional and domestic commitment are highly essential and a balance has to be maintained.

3. Contentment about Personal possessions, whatever is judiciously earned.

4. Positive attitude towards any problem.

5. Shedding EGO.

105

Mental Health…

EGO

EGO is defined as undue assertion

of oneself due to -

1. Position (in administration)

2. Monetary Status (in the society)

3. Relationship (in the family)

You are recognized only by your-

CHARACTER,

CONDUCT,

EFFICIENCY and

CONCERN for others.

106

Mental Health…

Four Important Steps:

1. Mandatory ANNUAL HEALTH CHECK-UP consisting of a Clinical

examination by a Competent Physician & simple urine and blood

tests for every one after the age of 30 years. This is essential

because biochemical changes in the body precede much earlier than

the actual physical symptoms of a Disease.

2. Basic knowledge of common types of ailments so that

Preventive and Curative steps can be taken up.

3. How to assess your own HEALTH ?

4. Knowledge of FACTORS that PRESERVE and RESTORE one's Health.

Management of Physical Health

107

Tests as given on slides/page 109 and 110 plus any other test as advised by your Physician based on complaints you have and the clinical examination.

Executive Health checkup / Master Health check up has to be based after clinical examination first not the same package for everybody as offered by corporate hospitals. It does not serve Patient’s requirement at all.

A Physician should clinically

examine before the tests are ordered.

Annual Health Check-up Tests (For every Couple above 30 Years of age within one week after anniversary)

Physical Health Management - STEP I

Tests have to be for individual requirement, not

what the hospital sells.

108

A) For Everyone (Basic tests required)

1. Complete Urine examination

2. Complete Blood picture, ESR

3. a) Fasting blood sugar

b) Post glucose blood sugar

( Minimum of 75 g. glucose or 1 g. / kg body weight given immediately after fasting

sample and then next sample to be drawn again one hour after glucose intake.)

4. Blood Urea

5. Serum Creatinine

6. Serum Cholesterol & lipid profile

7. Serum Uric acid

8. Prostate Specific Antigen (PSA) estimation for men after 40

• Go to the laboratory after 8 a.m. with no tea or coffee even without sugar in the morning (can take water);

• But, Remember, to finish the previous night's dinner before

8 p.m. i.e. 12 to 14 hours of fasting required before the blood sample given next day morning.( Otherwise all the reports would be wrong)

Annual Health Check-up Tests (For Couple above 30 years of age)

Annual checkup cont’d…

109

B) Additional tests for some people

9. ECG - (If there is a family incidence of Diabetes.M, Hypertension and

Heart attacks).

10. Stress ECG - (TMT Once in 2 years after 40 years for men).

11. Plain X-Ray Chest PA & LAT Views -

(If the individual is or was a smoker until last year).

12. Liver Function Tests - (If the individual takes Alcohol more than 2-3

times a week).

13. Ultra Sound Abdomen - (go to the Lab. fasting in the morning after

drinking 1 liter of water taken ½ an hour before).

14. PAP'S Staining of Cervical Smear -

(for women to detect Uterus cancer early)

15. Mammography - for women if a lumpy / nodular feel in the Breast,

Blood stain discharge from nipple, retraction of nipple / Skin in the Breast.

*Any other additional tests as advised by your Physician.

Annual checkup cont’d…

110

Appointment should not be easily available.

Long wait in spite of reaching Physician’s Chamber on time.

Doctor should not talk much with the patient, and if questions are

asked he should pull up the patient.

Prescription should cost more than the Consultation fee.

Longer the Prescription, better is the Doctor.

One of the Medicines is unheard of & Not easily available.

Patients’ views about a “Competent Physician”!

111

Competent Physician …

Commercial trend of Corporate hospitals

“Hospitalize in intensive care after scaring the Patient, for minor ailments or for even an ordinary fever”, is a new trend in almost all Corporate Hospitals of Cities in India.

“Scare the patient’s kith and kin and colleagues to hold the patient for as many days as possible in the intensive care unit. Carry on most of the unnecessary, expensive, cumbersome investigative procedures & involve as many Specialists as possible etc., is the order of the day.”

My question to this approach is - Where is the cost effectiveness of treatment? Where is the skill of the doctor? How many people can afford such a treatment in a developing country like India? and those who can afford, is the ordeal worth going through?

112

Commercial trend of Hospitals…..

Diabetes treatment Irrational trend…

• Physicians & Specialists are writing “Veterinary dose” of Diabetic medication and patients are not told to watch and report back Hypoglycemic symptoms. If sugar levels fall below 40 mg/ml for more than 3 minutes, Brain can be dead irreversibly and patient will become a vegetable for the rest of his life, confined to hospital requiring “Coma care”.

• LOW BLOOD SUGAR SYMPTOMS: Sudden onset of extreme weakness, a sort of drained out feeling, Sweating, Palpitation, drowsiness.

• If patient immediately takes 3-4 tea-spoons of sugar in water, eats

a chocolate or drinks 1-2 glasses of fruit juice or even soft drink, he will survive the attack, otherwise he will drift into unconsciousness and has to be shifted to a nearest hospital emergently for 50% Intravenous Glucose injection.

• Low sugar levels are more dangerous than high sugar levels.

Every Medical Professional has been taught and patients are to be made aware of this while prescribing medication for Diabetes.

IRRATIONAL PRESCRIPTIONS OF DRUGS IN DIABETES.M

113

• High dose of oral medication to recently diagnosed cases is shocking. Oral Hypoglycemic drugs, 200 times more powerful than the first generation drugs are being prescribed by Specialists and Diabetic clinics. Some companies are manufacturing and Physicians are prescribing a tablet containing 2-3 sugar lowering medication!

• It has been seen that a drug that acts for 24 hours, is being prescribed 2 or 3 time a day! This is nothing but Outrageous.

• This results in unusual increase in appetite, episodes of extreme hunger, compulsiveness to eat at odd hours of the day including in the middle of the night (Binge eating) weight gain. How can this Diabetic patient follow the “Diet” given by the Diabetic Specialist.

• Some of these drugs given excessively, force/stimulate directly Beta cells of Pancreas to secrete Insulin and can destroy Beta cells of Pancreas within a few months to a year or two due to chemical exhaustion. Ultimately, this patient becomes Insulin dependent Diabetic life long.

• Human body normally secretes 35-50 units of Insulin in 24 hours to maintain sugar levels normal in a non Diabetic person. But, doses of 70 to 120 units/day along with oral hypoglycemic drugs (most unjustified) are being prescribed to Diabetic patients particularly after “pens” have come into the market.

Diabetes treatment Irrational trend cont’d…

114

The insulin remains in the fat resulting in high blood sugar levels (as the blood vessels are sparsely distributed in the fatty tissue of the skin) or if the needle hits close to a blood vessel, or gets into a blood vessel, the sugar levels drop rapidly within minutes causing hypoglycemia. “Good opportunity” to shift the patient to Intensive care unit. This is the main reason of uncontrolled and highly fluctuating blood sugar levels.

Insulin has to be administered SC (Sub-Cutaneous) i.e. beneath the fat of the skin as shown in Page/Slide 115. Unfortunately, after Pens and Insulin Cartridges have come to the market with only 5.5 mm needle length, the patients are advised to take on the abdominal skin which is more than 5 to 10 centimeters thick. These days, when pens have come into market, there is no way to check whether the needle tip is in the blood vessel before delivering Insulin after the needle is pierced into the skin!


Blood Sugar levels have been highly fluctuant and never normal in these cases. This is a new trend, seen during the last 10 years and nobody in the Medical fraternity seems to be bothered to find out the reason. Even educated Patients are not aware of this.

115

Insulin administering needle should always be 12.5 mm in length

whether one is using “The Pen” or “disposable syringe” so that

Insulin is delivered beneath the Fat of the skin rather than in the fat.

NOT AS SHOWN BELOW


116 as shown in the next Page/Slide



117

Irrational Thyroid prescription- trend cont’d…

A new trend of prescribing Thyroxin even though T3 & T4 levels are NORMAL

(not recommended in Physiology), has been in vogue during the last few years with

the pretext of “Subclinical Hypothyroidism”. Modus Operandi - The patient is

usually put on 25 mcg/day based on marginally high TSH (which is the normal case

physiologically at 9 a.m., when blood sample is given). If this dosage is given to a

normal person, one does not show any symptoms. But, this is gradually increased to

50, 75 and 100 mcg/day every 4th month visit to the Endocrinologist. Patient is also

made to get convinced that this thyroid medicine has to be taken Life Long.

* Such Patients (who are on 75 mcg or 100 mcg Thyroxin), show symptoms

of- irritability, anxiety prone, quarrelsomeness, argumentativeness, Insomnia,

sometimes increase in appetite with weight gain, palpitation, frequent bowel

movement, Menstrual disturbances etc. Thyroid hormones are very powerful and

increase activity (metabolism) of each and every cell of the body.

TSH is secreted by Pituitary gland (situated below the Brain) to regulate Thyroid

gland for secreting the required T3 & T4 depending on their blood levels through

out 24 hours. It is most unjustified to prescribe Thyroid medication just based on

high TSH levels when T3, T4 are within normal range.

118

T3 & T4

From Thyroid in the Neck

TSH

from Pituitary Gland

situated under

the Brain

Pituitary control of Thyroid in the

secretion T3 & T4 through TSH

Prescribing Thyroxin

just based on

marginally or moderately

increased level of TSH

when

T3 & T4 are normal, is

most unjustified.


119

It is a Physiological fact that in the night during sleep, T3 and T4 levels drop to lowest levels to bring down the metabolic activity of each and every cell of the body, including that of Brain, Heart, Intestines etc. That is how the body gets rest and recoups during sleep. Hence the TSH levels are high from 2 a.m. to 6 a.m. in the morning and from 6 a.m. to 6 p.m. during the next day, return to normal range. When blood sample is drawn at 8 a.m. or 9 a.m. in the morning for TSH estimation, it is bound to be beyond normal range in majority of people. What about number of symptoms & signs of low functioning of Thyroid i.e. Hypothyroidism, taught to every Medical doctor? Where is the rationality in prescribing Thyroxin, not considering them and when T3, T4 levels are Normal?


120

121

Factors that increase TSH level:

Strenuous exercise, Lack of Sleep, Psychiatric

medication and autoimmune diseases.

Common Drugs that lower T3 & T4 Levels: Pain killers like - Diclofenac, Salicylates, Fenclofenac,

Naproxen, most of Anti epileptic drugs, Nicotinic acid

and Steroids.

“In Autoimmune Thyroiditis, I understand that Thyroxin is being prescribed based on high TSH levels in spite of T3 And T4 being normal. How does it help the antibodies to come down, and is not justified. Thyroid peroxidase antibodies in Hashimotos’s Thyroiditis and TSH receptor blocking antibodies (Hypothyroid variant of Graves diseases) can lead to Hypothyroidism. Thyroid autoantibodies are common in healthy population. These are only of academic interest for medical field and not in the welfare of the Patient.”


A) Basic Knowledge of Common day-to-day Ailments

Physical Health Management - STEP II

Today, the Educated Patient is committing the biggest blunder in

handling the above simple problems and paying a very heavy

price in the long run. Do you know how ?

Cold, Sore-throat,

Headache, Nausea, 1 - 2 Vomitings,

2 - 4 Loose motions,

Indigestion,

Abdominal discomfort,

Lack of Sleep,

feeling of Vague Sickness,

Body-aches, Fever, etc.

122

In the case of Fever, when an Educated Patient goes to a Consultant

Physician in India and in third world countries, 95% of them give the

following type of prescription on the very first day of the fever.

Patients literally compel the Doctors to write such Prescriptions.

1. Artesunate 60 mg tab 2 bid for two and half days (for Malaria)

2. Ciprofloxacin 500 mg tab bid x 5 days (for Typhoid)

3. Co-trimoxozole - DS tab 1 bid x 4 days (for UTI)

4. Stemetil tab 1 tid

5. Calpol tab 1 qid

6. Incidal tab 1 tid

7. Cobadex cap1 od

8. Santaveni tonic 2 tsp bid

9. Diet - eat whatever you want & rich food !!

123

Day to day ailment…

Fever subsides next day. What was the fever ?

Was it MALARIA ?

Was it TYPHOID ? or

Was it URINARY TRACT INFECTION ?

Nobody can make out because it was a Pharmacological

“gang rape” of the fever!

Patient discontinues Ciprofloxacin after two days, because he

thinks it is too expensive, powerful and harmful.

Fever recurs on the fourth day and continues for weeks creating

confusion about the diagnosis as the pathological or biochemical tests

subsequently are inconclusive, and Specialists start labeling it as

PUO / FUO (in USA).

“Pyrexia of unknown origin” “Fever of unknown origin”

124


Changed abbreviation for an undiagnosed

Fever lasting for more than 21 days is –

P P P

P - PERSISTENT for the PATIENT

P - PERPLEXING for the DOCTOR

P - PYREXIA means FEVER !!!

125


In all the day-to-day ailments, the initial treatment should be….

Skip the next solid meal for a few hours to 48 hours;

Remain on suitable Liquid Diet;

Take at least 8 to 10 glasses of plain Water in 24 hours;

Take rest if Temperature is high and can take Paracetemol

every 6th hourly even on empty Stomach.

# Seek the Family / Company Doctor's advice if symptoms

do not show decline in 48 hours.

# In 80 - 90% cases, No tests, No medication and

No Doctor will be required.

126


In an Acute Illness when one does not follow Dietary restriction

the Medicine doesn't work!

When one follows Dietary restriction, there is no need of any Medicine!

There is an important principle in Ayurveda,

the oldest traditional (Alternative) system in INDIA-

127


Fasting, Food & Nourishment

You are not nourished by what and how much you eat. You are nourished by what you are able to digest, absorb and assimilate (oxidize) with enough physical exertion.

In all acute ailments, digestive system is shut down because mastication, ingestion, digestion, absorption of food are energy spending processes. This is the reason why all mammals abstain from solid food during injuries and acute illness which is a natural instinct.

Fasting and Starvation are not synonymous. Starvation starts when a person continues abstaining from solid food after his Glycogen and Fat stores of the body are exhausted.

This is the fundamental basis of “Fasting therapy”


128

A patient with 104 F temperature, splitting headache, bitterness in the mouth, coated tongue and vomiting sensation – How can he have solid food and how can Physicians advise him to have rich food or not advise on diet restrictions at all?!!

*Educated Patients are under the illusion that all allopathic medicines have to be taken after food.

If rich food is synonymous with more energy and calories in the

body, then an asthenic or a lean person should put on weight in a few

weeks time and in all acute infections the person should be able to

recover with good food while antibiotics would become redundant.

O

129


“Your body has remarkable recuperative power when it is left alone.” Though, Dr. Shelton had said this in 19th Century, it is not correct at all today, because the Physician has to keep a watch on the patient for serious infections and other diseases where morbidity or mortality can result when body’s recuperative power is not sufficient enough. All Naturopathic Physicians should make a note of this.

“We unfortunately, interfere too early, too often and too much with it due to pessimistic approach and over cautiousness.” This is true even in the present day scenario in 90% of ailments.

Dr. Herbert. M. Shelton

130


The role of a Physician was to assist these natural forces by creating most favorable conditions for healing process.

This is the actual meaning of Therapy which comes from the Greek word “Therapeuin” means to attend.

Today, instead of assisting the body, we are substituting and interfering with it's recovery process.

In 400 B.C. Hippocrates, the father of Modern Medicine, recognized the

healing forces inherent in living organism. He called these forces-

“NATURE’S HEALING POWER”.

131

Non interference with …

Do all Allopathic Medicines require food intake

prior to administration ?

Only the following group of the Medicines and some

specified medication have to be taken orally after food.

A. Analgesics and Analgin, Aspirin, Saridon

anti-inflammatory Anacin, Brufen, Nimesulide Drugs: Ibugesic, Voveran, Mobizox Indomethacin, Ultracet etc.,

B. Anti-malarial drugs: Chloroquin phosphate (Lariago),

Pyralfin / Malocide / Metakelfin etc.,

Decadran, Betnelan,

C. Steroids: Betnesol, Omnacortil,

Wyselone, Deltacortil,

Prednisolone etc.,

132

Every medicine does not require food …

No

In fact, most of the antibiotics like - Ampicillin, Norfloxacillin,

Rifampicin, Ciprofloxacillin etc., have to be taken on an empty

stomach. (excepting Erythromycin & a few others, as specified

by the Physician)

Do you know that one type of oral Diabetic medicine (Sulfonylurea group) and Insulin have to be taken half an hour before food intake? The other oral medicines (Biguanides, Meglitinide derivatives) have to be taken immediately after food?

These days some pharmaceutical companies in India are

manufacturing both or sometimes three generic different

medicines in the same tablet. When should this tablet be taken?!!

Medicines for Heart and Blood pressure can be administered on

empty stomach, maintaining time schedule is very important.

133

Every medicine does not require food …

Doctor does not prescribe treatment in USA until diagnosis is confirmed

Doctor - patient trust is totally non existent in USA.

The Patient is subjected to a number of tests- expensive and cumbersome. No conclusion is drawn even after the test results come. The Patient is referred to other specialists who in turn put him through further tests pertaining to their respective specialties.

“Joint responsibility is no responsibility!”

This is what is known as defensive Medicine. The Doctor all the time tries to save his own Neck, regardless of whatever may happen to the Patient.

WHO IS AT LOSS ?

“This is what is happening in all developed countries of west and unfortunately, in recent past same thing is creeping into India.

134

Diagnosis &treatment in USA…

Doctor - Patient Rapport

If a Patient does not trust the Doctor and the Doctor does not trust the Patient, How can the results be achieved even from the best treatment particularly in day to day ailments & in Chronic Diseases ?

This is exactly what is happening in the West and same thing has crept into India these days.

The way it is practiced mostly is the Defensive Medicine, and it is neither in the interest of the patient nor the economy of any country.

135


A 30 year old CEO of his own company in Detroit, had seen a few years ago, at least 15 Specialists in 3 months period without attending to office for reeling sensation and heaviness in the forehead, spending around $ 50,000. Yet received no commitment on any Diagnosis, leave alone starting any treatment.

His own reports of investigations done extensively for three months in USA revealed Chronic Sinusitis and Cervical Spondylosis which were responsible for his symptoms.

Patient started worrying that if his problem could not be diagnosed in USA then it must be a very serious, mysterious & incurable problem and consequently developed Anxiety Neurosis for which he was referred to a Psychiatrist!

136


Mere diet restrictions for i) Sinusitis, Breathing exercises, Jalanethi, a yogic kriya & for ii) Cervical Spondylosis -Spinal Exercises with clear instructions about mattress & pillow, massages and muscle relaxing treatments like fomentations & steam baths solved his problem in 4 weeks period in Hyderabad, India.

Guess the expenditure! `6000/- only ($ 130) in a month’s period. He was given instructions on mattress, pillow and sitting and working postures to prevent recurrence of the problem. He had also been advised to carry on 10 minutes Spinal exercises (extension, lateral flexion & spiral bending of spine) regularly, at least 5 to 6 days in a week, to maintain Spine flexibility.

No treatment was required for his Anxiety Neurosis!

137


Why could this patient not be treated in USA ?

They were cautious in investigating all the possible causes for reeling sensation and heaviness in forehead as given in the Text book of Modern Medicine involving- a General Physician, an ENT

specialist, a Neurophysician, a Neurosurgeon, an Orthopedist, an Ophthalmologist and a Psychiatrist too of course.

“Too many cooks spoil the broth” aptly applies here.

It would have been reasonable, at least if some of the Doctors concerned from the panel given above, started treatment for Sinusitis and Cervical Spondylosis, which had been indicated in their own reports.

This is like- “Chasing the Goose when it is in one’s own lap”!

138


It was because they knew that they cannot give total relief to the symptoms of the Patient through modern Medicine. They were apprehensive that patient might sue them if there was no relief. Added to their misfortune if there is an additional cause detected later in the tests, then it will definitely add to legal hassles for the treating Physician.

Allergic upper respiratory problems, require diet restrictions which reduce congestion & mucus production and this fact ENT

specialists and chest physicians are ignorant about, in modern medicine.

& mattress play a crucial role in symptoms like vertigo due to Spondylosis, which is not known to the Orthopedic Surgeons and Neurophysicians world over.

Why was he not treated for Sinusitis & Cervical Spondylosis?

139

DiagnosisPillow &treatment in USA…

Chemotherapy for all types of Cancers How far are we justified ?

• Chemo-therapeutic drug in Cancer patient, when given, cannot identify the Cancer cells. It destroys all the cells that usually multiply constantly in the body. (e.g.- WBCs, lining of the Digestive tract and Urinary tract, Hair follicle, Ovaries and Testes etc.) Since, Brain cells never multiply, Brain is never affected in Chemotherapy. • A dose that can kill all the Cancer cells in the body, will be lethal to the Patient. Hence, the dose given is always sub-lethal dose, where a few Cancer cells are definitely spared in some corners of the body, which eventually show their fangs within no time. That is why in Medical field, Oncologists talk in terms of 2 year & 5 year survival rates with some statistical data. If a patient does not have recurrence after surgery, Chemo. and Radiation, In oncology it is considered as CURE! There is no uniformity of approach in all Cancer Institutes across the world. These institutes have as many combinations of drugs as the number of institutes, so called “Chemotherapy protocols” for the same Cancer, which patient and the relatives never can understand. Meanwhile, treatment becomes much worse than the disease itself !

• It is the patient’s prerogative, to undergo the Chemotherapy or not to. But patient should be given all the details factually because quality of life is more important rather than the extended miserable life. But here the question is, How can Medical Oncologist have work on hand? Most of the times in these cases, death occurs prematurely due to the Chemotherapy in India, due to improper monitoring, compromised sterile facility at every level .

Cancer treatment cont’d….

140

Chemotherapy and Radiation treatment in Cancers

• Radiation treatment is curative only in a very few types of Cancers and is used as an adjuvant, after surgery. Samarium 153 Intravenously and Radiation are useful for relieving pain in bony metastasis when Morphine does not give relief.

• CRUX of Cancer treatment in Modern Medicine depends on early diagnosis and immediate surgical intervention in malignant ulcers, tumors, Cysts, Bony growths and lumps. (Never forget to collect always for a second opinion, the Histopathology slides and Paraffin blocks, while collecting the histopathology report, immediately after surgery).

• Each Cancer of hundreds of types, behaves in different ways. Basal cell carcinoma never spreads even regionally to lymph nodes. Melanoma though small, can spread all over the body by the time it is diagnosed. There are Cancers that cannot cause fatality for one or two decades in spite of not treating.

NOTE : As on today Chemotherapy is curative only in certain type of malignancies like: Choreo-Carcinoma, Acute Lymphocytic Leukemia (ALL) of childhood, Burkett's tumor, Hodgkin's disease, Acute Promyelocytic Leukemia, Large follicular center cell (diffuse histolytic) Lymphoma, Embryonic Carcinoma (Seminoma) of Testis and Hairy cell leukemia (probable).


141

High Frequency Radio-ablation, De-bulking of tumor mass, thrombosis of the Artery going to Tumor etc., are only of academic importance. They are of no help to patients except increasing the misery and costs.

In all Malignancies, take always 2 or 3 opinions– Weigh Pros and Cons and then only decide for the treatment, remembering that quality of life is more important than the borrowed miserable time. Patient has to be explained all the details factually (not giving false hopes with Statistics) by the Oncologist and the family should be in a position to take the decision without considering what others think for not treating in a terminal case. Keeping patient at comfort, Physically and mentally, should be the objective. In untreatable Cancers, Patients live longer when not treated and are more happy to be at home with their loved ones. Such patients require symptomatic treatment only and medicines for pain relief and sleep. Here, Family Physician’s role becomes very crucial to handle at Home.

A philosophical and Spiritual approach to life, helps a lot in

these patients to face the inevitable eventuality.


142

Human body & its Defense

Do you know that if our defense system fails, it takes only 4 sec. for the Bacteria to reach Brain

from a fresh superficial wound in the hand and cause fatal Meningitis or Encephalitis.

1. 126 Billion white cells (WBC) in a 70 kg person

2. Anti-bodies 3. Complements: C1 – C17

Antibody Harmful Chemical

Antibody

WBC

WBC

Bacterium

Neutralized

Complement Bacterium

Cell wall

destroyed

Bacterium

143

DATE 6 a.m. 12 Noon 6 p.m. 10 p.m.

1/9 99 100 101 102

2/9 100 100.6 102.4 103

3/9 100.4 101 103 104

4/9 101 101.6 103.4 104.2

A proper temperature chart can give a clue to diagnose a FEVER

In a case of Fever, temperature chart is very important to suspect or diagnose the type of fever. Many people do not have the slightest idea about it and those who maintain "some" Temp. chart have no relevance.

A good Temperature Chart in a case of Fever:

Paracetemol 500 mg tablet or syrup 125mg / tsp. depending on the age of the patient,

can be given only at the above timings if the temp. is above 98.4 F, not in between. O

144

B) Chronic Diseases

I. Birth defects

Can be prevented by avoiding...

- Medication of any type

- X-rays to any part of the body

- Scans during the 1st three months of pregnancy

The development of organs in the Fetus takes place during the first three

months of pregnancy and anything that interferes during this period can

cause Birth defects.

A Defective child is a life long liability and Stress.

Like any manufacturing defect cannot be totally corrected,

God's manufacturing defects are much more difficult to handle.

Only an Obstetrician is competent to prescribe.

145

Physical Health Management - STEP II

II. Hereditary Diseases

Diabetes Mellitus (High Blood Sugar)

Hypertension (High Blood Pressure)

Coronary Artery Disease (Angina and Heart attacks)

A Person with Family History of above problems, has to take

certain precautions after the age of 20 as shown in the next

slide; Otherwise he will develop the problems much earlier

than his Parents had.

50% of our Health is Inheritance. The other 50% we mess up

due to Ignorance & Negligence.

146

An Individual with a Family history of Diabetes.M., High blood

Pressure and Heart-Attacks, has to take the following:

1. Cannot afford to be *Over-weight.

2. Cannot take Oily foods, (particularly saturated fats)

& Sweets liberally. The list of foods in daily life

containing saturated fats which promote bad

Cholesterol (LDL) in the blood is given in the

next slide.

3. Cannot go without regular Exercise.

4. Cannot indulge in Smoking.

5. Cannot afford to take Alcohol liberally.

FIVE PRECAUTIONS:

147 *refer to Charts on Pages/Slides 150 & 151

Foods containing saturated fats in our daily Diet

Non-vegetarian Foods (Meat, Beef, Pork, Prawns, Crabs,

Chicken, Fish etc. & Eggs).

Dairy Products like:

- Whole milk

- Curd

- Cream

- Cheese

- Butter

- Ghee (butter-oil)

- Milk Sweets & Desserts

- Milk chocolates

- Milk beverages

“Vanaspathi”(Hydrogenated oils)

Coconut oil

Palm oil

A few of the items given above can be minimized or avoided to reduce total Cholesterol levels particularly LDL & VLDL in the blood.

148

Should you stop the consumption of Vegetable Oil in diet to reduce excess Cholesterol in the Blood ? - NO.

One who has high Cholesterol levels, should cut down animal source of Fat (saturated fats) in the Diet and never reduce the intake of vegetable oils (unsaturated Fats) otherwise it will result in Total Cholesterol in blood to go up due to break down of body fats and pooling into blood.

In Diabetics- Control of blood sugar levels, In Hypothyroidism, maintenance of T3, T4 & TSH levels are more important along with Diet and Medication to bring down Cholesterol levels.

One should continue to use normal quantities of Vegetable oil in diet, but reduce Animal source of Fats, hydrogenated Veg. Oils & Coconut & Palm oil for reducing Bad (LDL) Cholesterol.

Hence, one can have fried stuff as long as it is in Vegetable oil Ref- page 269, 13th edition “Rypins’ Medical Licensure Examinations”

149

Height Small frame Medium frame Large frame

Ft In Cm lbs kg lbs. kg lbs kg

5 2 157 112-120 50-54 118-129 53-58 126-141 57-64

5 3 160 115-123 52-56 121-133 55-60 129-144 58-65

5 4 163 118-126 53-57 124-136 56-62 132-148 59-67

5 5 165 121-129 55-59 127-139 58-63 135-152 61-68

5 6 168 124-133 56-60 130-143 59-65 138-156 63-70

5 7 170 128-137 58-62 134-147 61-67 142-161 64-73

5 8 173 132-141 60-64 138-152 63-69 147-166 67-75

5 9 175 138-145 62-66 142-156 64-71 151-170 68-77

5 10 178 140-150 64-68 146-160 66-73 155-174 70-78

5 11 180 144-154 66-70 150-165 68-75 159-179 72-81

6 0 183 148-158 67-72 154-170 70-77 164-184 74-83

6 1 185 152-162 69-74 158-175 71-79 168-189 76-85

6 2 188 156-167 71-76 162-180 73-82 173-194 78-88

6 3 191 160-171 73-78 167-185 76-83 178-199 80-90

6 4 193 164-175 74-79 172-190 78-86 182-204 82-92

Ideal weight for Men

Ref.: Extract from “Hatchison’s clinical methods”. 150

Height Small frame Medium frame Large frame

Ft In Cm lbs kg lbs kg lbs kg

4 10 147 92 -98 42-45 96-107 44-49 104-119 47-54

4 11 150 94-101 43-46 98-110 45-50 106-122 48-55

5 0 152 96-104 44-47 101-113 46-51 109-125 49-57

5 1 155 99-107 45-50 106-116 47-53 112-128 51-58

5 2 158 102-110 46-50 107-119 49-55 115-131 52-59

5 3 160 105-113 48-51 110-122 50-55 118-134 54-61

5 4 163 108-116 49-53 113-126 51-57 121-138 55-63

5 5 165 111-119 50-54 116-130 53-59 125-142 57-64

5 6 168 114-123 52-56 120-135 54-61 129-146 60-66

5 7 170 116-127 54-58 124-139 56-63 133-150 60-68

5 8 173 122-131 55-59 128-143 58-65 137-154 62-70

5 9 173 126-135 57-61 132-147 60-67 141-158 64-72

5 10 178 130-140 59-63 136-151 62-69 145-163 66-74

5 11 180 134-144 61-65 142-155 64-70 149-168 68-76

6 0 183 138-148 63-67 144-159 65-72 153-173 69-79

Ideal weight for Women

Ref.: Extract from “Hutchison's clinical methods”. 151

• 90% of people hailing from Middle class, upper middle class and from the elite

section of society, are Obese across the World.

• It is due to heredity tendency, food habits of the Family and both.

• Anybody who has 9-10 kg excess weight than the “Ideal” weight given in the

Standard Weight Chart is Over-weight.

• BMI ( Body mass Index) is calculated by –Body Weight in Kg divided by Height

in Meters square.

• GRADES OF OBESITY- Normal BMI: 18.5 - 22.9 kg/m2

Overweight: 25-0 - 29.9 kg/m2

Grade I : 30.0 - 34.9kg/m2

Grade II : 35.0 - 39.9kg/m2

Grade III : > 40 kg/m2 (Morbid Obesity)

Obesity is a risk factor for a number of diseases like: Diabetes, High blood pressure,

Coronary Heart Disease, wearing out of weight bearing joints- Knee, Hip & Ankle, Gall

stones, Varicose veins, Lumbar and Cervical Spondylosis and even Cancer-Colon,

Rectum, Prostate, Breast, Biliary tract & Ovaries.

Obesity is a disease, not the sign of Prosperity

* Those who are very Obese from their teens are prone to die young of Heart attack.

Gross difference in weight compared to that of spouse affects Sexual life. 152

Diet for Weight reduction-(in 24 hours) + a little exercise feasible on daily basis.

3 cups of coffee/tea with sugar + One time Fruits (except Grapes) and Salads (no salt), One

time cooked food based on their traditional taste preferably as Dinner, avoiding Sweets ,

Desserts, Pickles, Chutnies, Papad and all other food items that contain lot of Salt. Take

water 250 ml once in 2 hours ( 2 Liters in 24 hours intermittently). No in between eating.

Remain on only liquid diet (10 times) on Mondays and Thursdays. Like: 3 time coffee/tea, 3 times Fruit/veg juices, 3 times Honey water 3tsp each

time plus 4 glasses of water in 24 hours. Note – No salt in any of these liquids.

Check weight only once a week on Friday morning

How to reduce Weight Either one has to Eat less than one is physically exerting or Exert more than

One is eating- “This is the Universal law for weight reduction.”

If one has to reduce by exercise or workout, then he/she has to spend 4 to

6 hours a day which is possible only for film Heroes and Heroines as they

lose in millions of money per film and even their Careers.

Professionals, Office goers, Working people, Post-graduate students- How can they

find so much time? The only way is to go on a reasonable and implementable Diet

on long term basis and half an half hour exercise till the target weight.

153 *One can lose one kg per week following the above regimen. Take up dieting only if you

want to achieve the Target weight.

Certain Foods have bearing on precipitating or

aggravating an Allergic problem. Do you know ? Modern Medicine Doctors are totally ignorant

about it as they have not been trained on this

aspect. This is precisely the reason, that the

desired relief does not come in spite of a battery of

Medications. Fish and Sea-foods are well known

for triggering Allergic reactions in some people.

In Bronchial Asthma & Allergic problems

154

Allergic problems….

In Allergic problems...

The food stuffs (list shown in Pages/Slide 157) have to be

avoided for 1 to 6 weeks, prior to or during an attack of

common Allergic problems like :

A. Respiratory - Rhinitis

Allergies - Sinusitis

- Allergic Pharyngitis

- Allergic Bronchitis

- Eosinophilia

- Bronchial Asthma

Note: In B & C (diseases indicated in the slide 156), the food stuffs specified

in slide 157 will have to be withheld 100 % for a few Months to a Year or Two..

C. Auto- Immune Diseases

B. Allergic Skin Problems

155

Allergic problems & Auto-Immune diseases….

What is an Autoimmune Disease?

In Autoimmune diseases listed in the box below, the antibodies produced

in the body against Bacteria in the past, start attacking one’s own tissues

causing chronic inflammation and serious impairment of the organs

affected and sometimes permanent residual damage.

In Modern Medicine there is no treatment excepting using Steroids and anti-cancer medicines to give symptomatic relief.

Autoimmune diseases:

Rheumatoid Arthritis (multiple Joints), Psoriatic Arthritis (multiple joints),

Psoriasis (Skin), Pemphigus vulgaris, Pemphigoid (Skin), Scleroderma (Skin),

Lichen Planus (Skin), Leucoderma (Skin), Ulcerative Colitis (Colon), Multiple

Sclerosis (Nerves), SLE (Connective tissue of Skin, joints, kidneys & other

organs), Sarcoidosis (disease of unknown reason affecting Lungs), Ankylosing-

Spondylitis (Inflammation of whole spine, a crippling disease), Idiopathic

Thrombocytopaenic Purpura (Platelet depletion in Blood), Collagen Disease

(Connective tissue of multiple organs), Amyloidosis (infiltration of tissues with

insoluble Protein fibrils), Eale’s Disease (Eye-Retinal allergic vasculitis),

Myasthenia Gravis (weakness of muscles of face and swallowing, & later other

muscles) Oligospermia (Low sperm count < 5million) and many more such

diseases…..

156

1. Animal source of protein:

Milk, Curd, Butter Milk, Butter, Cheese, Milk Chocolates, Milk

Beverages, Milk Sweets / Desserts, Eggs, Non-vegetarian foods.

2. Foods containing: Colors, Preservatives, Synthetic food additives:

Soft drinks, Sauce, Jam, Jellies, Ketchup, Colors in Sweets, Pastries,

Cakes, ready to eat packed foods, Bread, Biscuits, Chocolates, Toffees etc.,

3. Certain Fruits

Grapes, Citrus fruits like Lemon, Oranges, Sweet lime, Guava, Custard apple,

Pineapple, Gooseberry, raw Tamarind, raw Mango & other sour fruits and

raw sour vegetables.

Permissible Fruits like: Banana, Apple, Papaya, Sapota , Melons, Jackfruit,

Pears, etc. can be taken before 7 p.m.

Since restrictions are for a long period in skin problems and in Auto-immune diseases, one can have Calcium & Vitamin D

substitution prescribed by the Physician.

Foodstuffs to be avoided

In Allergic conditions and Autoimmune diseases

157

Allergic problems cont’d….

One may wonder what is left for eating?

Green tea, Black tea or Coffee, All varieties of Vegetables (non sour) including Tubers, all Pulses (Proteins- except of animal source), all Cereals (carbohydrates), normal Salt, Chillies, other spices, fried foods and even baked preparations.

Non-citrus fruits like - Banana, Papaya, Apple, Sapota, Jack fruit, ripe Mango, Water melon, Musk melon, Pomegranate, Pear etc.,

The following foodstuffs one can have:

There is no choice either !

Not at all difficult to follow for a few weeks to a few months.

Not Life long ! Otherwise, It is not worth Living !

158


How this list of “food stuffs to be avoided” has been arrived at ?!

Based on practices regionally by various communities in

India that have been passed on from one generation to

another during the past few centuries.

My own parents with more than 40 years of experience,

who were renowned Naturopaths in India (1950-98).

Various restrictions prescribed by Indian systems

(Alternative systems) of Medicine in certain diseases.

Our own clinical experience of over 35 years.

Response to these restrictions for a limited period, has been overwhelmingly encouraging. It

is for the Modern Medicine (Allopathic) to take up research to standardize the regimen and

also to look into objectively, what ingredients in Animal Protein, Synthetic colors, food

additive, preservatives and citrus fruits cause aggravation or precipitation of Allergic and

Autoimmune Diseases. 159


III. Acquired diseases

Infections - Viral fevers - Typhoid - Brucellosis - Leptospirosis - UTI - Pneumonias - Tuberculosis - Hansen's disease etc.,

Metabolic Diseases

- Diabetes Mellitus - Obesity, - Gout - Dyslipidemia etc.,

Why people are getting prone to Infectious Diseases and

developing Metabolic Disorders even at a young age? 160

IV. Degenerative diseases (ageing problems)

- Cervical Spondylosis

(Neck problem)

- Lumbar Spondylosis (Lower back problem)

- Osteo-Arthritis

(of weight bearing joints like knees)

- Osteoporosis

(Depletion of Calcium from bones)

- Pre-Mature Cataract

(Lens of the eye getting opaque)

- Parkinson’s disease

(Imbalance of certain chemicals in the Brain)

Why is this

premature

ageing ?

161

These problems also have increased in incidence,

does any one realize why this trend ?

V. Diseases of unknown reasons even today in spite of all our advancements in diagnostic techniques

- Allergies

- Malignancies (Cancers)

- Auto Immune Diseases:

Rheumatoid Arthritis (multiple Joints), Psoriatic Arthritis (multiple joints),

Psoriasis (Skin), Pemphigus vulgaris, Pemphigoid (Skin), Scleroderma (Skin),

Lichen Planus (Skin), Leucoderma (Skin), Ulcerative Colitis (Colon), Multiple

Sclerosis (Nerves), SLE (Connective tissue of Skin, joints, kidneys & other

organs), Sarcoidosis (disease of unknown reason affecting Lungs), Ankylosing-

Spondylitis (Inflammation of whole spine, a crippling disease), Idiopathic

Thrombocytopaenic Purpura (Platelet depletion in Blood), Collagen Disease

(Connective tissue of multiple organs), Amyloidosis (infiltration of tissues with

insoluble Protein fibrils), Eale’s Disease (Eye-Retinal allergic vasculitis),

Myasthenia Gravis (weakness of muscles of face and swallowing & later other

muscles) Oligospermia (Low sperm count < 5million) and many more such

diseases…..

162

How to assess one's own Health ?

Ask yourself six questions:

1. Have I been getting proper Sleep these days ?

2. Do I have a satisfactory and spontaneous Bowel movement

everyday ?

3. Do I have a good Appetite ?

4. Do I enjoy my day's Work ?

5. Is my Chest measurement more than the Abdominal girth?

6. Am I cool and composed while dealing with people?

Physical Health Management - Step III

If answers to any one or more questions given above is not in affirmation, then your

Health is not alright. You don't have to rush to a Doctor or go through tests. What

you have to do is, to…

Bring in a little change in your Lifestyle.

163

Physical Health Management Step IV

Factors

that

preserve and restore

your

Health

164

Factors that maintain & restore Health

1. A regulated daily routine.

2. Good dietary habits in Health & Disease.

3. Regular yogic exercises.

4. Avoiding excessive indiscriminate medication.

5. Abstaining from:

Excess Tea / Coffee

Smoking Tobacco products

Narcotic Drugs

Excess Alcohol

6. A Philosophical & Spiritual approach to life.

Healthy Life style management

165

LIFE STYLE MANAGEMENT….

Factor that preserves and restores Health...

1 A

Regulated

Daily Routine

166

Physiologically, it has been proven that all our internal organs’ functions are conditioned to particular timings of the day.

Every Living being has a definite daily routine except educated human being!

A regulated routine, at least 6 days in a week, has a lot of bearing on our Health.

Good daily routine cont’d…

167

What is the remedy for people who have shift duties at the

workplace or night work for 8-10 hours as seen in the BPO

companies in India ?

What is the best Daily routine one can have ?

168


Daily routine Children ( < 15 years ) Adults

5.00 a.m. up from the Bed

5.30 a.m. Yogic exercises

6.00 a.m. up from the Bed

7.00 a.m. Breakfast

8.00 a.m. 8.00 a.m. BREAKFAST

1.00 p.m. LUNCH in 1.00 p.m. LUNCH

School

4.00 p.m. Seasonal fruits 4.00 p.m. TEA

+ Milk

8.00 p.m. DINNER 8.00 p.m. DINNER

10.00 p.m. Retire to Bed

11.00 p.m. Retire to Bed

Note: People working in shifts should know that no shift should be changed in less than 15 days.

169


Daily routine for people working at night on regular basis for months in BPO companies & other places

8.30 am : Bath followed by Light breakfast or

local fruits & a glass of Milk.

9.00 am : Retire to bed

SLEEP

3.00 pm : Up from sleep

4.00 pm : 25 minutes Yoga

5.00 pm : Bath

7.00 pm : DINNER

9.00 pm : Evening

WORK

8 00 am : Next day

Note: Drinking 1

Glass (250ml) of plain

water once in two

hours when awake

and at night solves

many a problem

including acidity.

One can have two

cups of tea / coffee

11p.m & again at 4.00

am during the work.

6 hours of uninterrupted

sleep is good enough.

170


Good

Dietary

Habits

2


171

Criteria of a good Diet

Should be pleasant to look at.

Should smell good.

Should taste good.

Should be nutritious.

Even if above four conditions are met,

the most important aspect is, it should

be of one's liking.

II Good dietary habits cont’d…

172 “Any food that is consumed with dislike or apprehension, is not digested at all”.

Good dietary habits...

1. Timings: should be fairly fixed.

If you are delayed by more than an hour or two,

skip the Meal, manage with fruits or liquids.

You may compensate what you have

missed in the next meal !

“An untimely meal is a Poison”


173

Part of a “Sloka” a verse from Ayurveda

People

Children below 20 years of age & pregnant women - 3 times

20 years to 60 years (a third helping of Fruits/salads allowed) - 2 times

Above 60 years - 1 time only

ONCE A DAY - IS A SAGE.

TWICE A DAY - IS A WORLDLY MAN.

THRICE A DAY - IS A SICK MAN.

That is - If you do not want any restrictions in the type of food,

Otherwise the moment restriction is imposed it will increase Stress.

2. How many times one should have cooked food in a day ?


174

One may eat a number of times in a day to prevent Acid Peptic disease as advised by Physicians of Modern Medicine, but one ends up:

Liver

Gall bladder

Stomach

Duodenum Common Bile duct

Duodenal

Ulcer

Pancreas

Pancreatic duct esophagus

(i) Eating more than required in the day, and if one restricts the quantity, one is not satisfied and will feel, that one has not eaten at all at the end of the day. Quantity plays a crucial role for Psychological satisfaction.

(ii) It leads to indigestion as secretions cannot be poured in so often.


175 *This does not apply to patients whose Gall-bladder is removed. They can have 4 small meals a day

How to reduce Salt in Daily Diet

Modern Medicine Physician or Cardiologist, today is never able to advice,

how to cut down salt in diet. He is ignorant because they have not been

trained. Their usual prescription is “Low salt and Low fat diet” as a last part

of the advice after writing medications. Consequently, the wife gives this

patient “ No salt and No fat ” diet. The patient follows for only 3 days. Then

he reasons –“It’s not worth living with this bland food, Let me eat and die”.

Since he must have consumed at least “5 quintals” of salt in his 54 year life

span. Salt less & oil less food is not at all palatable.

Salt reduction is the most important aspect of Medical prescription, apart

from medication particularly in cases of- High blood pressure, Heart

problems, Congestive heart failure, Cirrhosis of liver, Kidney dysfunction,

Pre-menstrual period and Women who are on Hormone therapy, in the third

trimester of Pregnancy, Obesity etc. (Hence, a diuretic has to be prescribed)


176

Excess Salt ingestion holds back water in the blood and if it is more than

5 Liters, can cause volume overload on Heart. Hence, water is pushed into Sub

cutaneous tissues (Skin) and body cavities- Body’s safety mechanism.

The Only Way to reduce daily Salt intake

• Convert 2 or 1 of the three times (Breakfast, Lunch, & Dinner) of solid cooked food intake in a day to Fruits and salads ( no salt ).

• Avoiding food items requiring high salt - Pickles, Chutnies, Papad,

Vegetables & Fruits soaked in salt and dried in sun for later use, food items with high content of tamarind / Lemon, Chilies & Spices.

• To remain on Liquid diet 8-10 times (not containing salt) + half to 1 liter of water whole day. This can be done for 3 days continuously, alternate days or biweekly. (same diet also helps in weight reduction).

• Habitual in between eating, intake of salt in food items over and above in spite of normal salt, adding salt to lemon juice, fruit juice, buttermilk and in some fruits etc., have to be avoided.

To reduce salt cont’d…

Every food preparation requiring salt has to have what is known as optimal salt. It can not be reduced even a pinch, as it will be

unpalatable to anybody particularly to the patient.

177

EGG is also considered as Non-Vegetarian from nutrition

point of view. Saturated fats in yellow of the egg and other

Non-veg items promote Cholesterol levels in the Blood.

tion

**Comparatively, Chicken & Fish contain least amounts of

saturated fats in Non-vegetarian foods.

3. Non-Vegetarian only twice a week after the age of 20


178

There is no enough Physical Exertion today, due to the luxurious Life to assimilate this rich food.

Liquids (excepting Alcohol) that can be taken throughout the day

until the next day morning are -

Not more

than

3 cups

Lime juice

Butter milk

Milk

Fruit juice

Coconut water (in 24 hours)

Clear soup etc.

Total 6 - 8 8 glasses

times + of

in a day water

Coffee, Tea, Boost,

Maltova, Horlicks etc..

4. Fast and be on Liquid Diet, one full day in a week (preferably Mondays) Fasting is not possible on holidays.


179

Fasting to be avoided by those...

Who are severe Diabetics on heavy dose

of oral Medication or on Insulin.

People who have Tuberculosis and are

under treatment.

Who are suffering from Hyperthyroidism.

Who are severely Anaemic: Hb < 9 g/dl.

Who have Hypoglycemic spells.


180

5. Water intake

(i) Never drink Water while taking solid food.

(can have before or after 10 minutes)

The reasons are:

a) Water occupies a certain volume in the Stomach

and one cannot eat proper quantities in the Meal.

b) The Hydrochloric acid which protects us from

various Bacterial, Fungal and Parasitic

infestations,

becomes ineffective due to dilution.


181

(ii) Throughout the day, one must consume a minimum of

2 Liters of Water, intermittently.

This prevents one from :

Water intake…

Mouth ulcers, Hyper-acidity, Heart burn, Gastritis,

Duodenal ulcer, Indigestion, Flatulence, Dyspepsia,

Constipation, Piles, Fissures, Fistula.

High uric acid levels.

Urinary stones

Gall stones


182

Most of the common Digestive problems are

due to Four reasons

1. Irregular timings of Food.

2. Eating number of times and in-between munching.

3. Drinking water with Food.

4. Not drinking enough Water throughout the day.

Water intake…


183

6. Hazardous ingredients in our daily Food

(i) “Vanaspathi” (Hydrogenated Vegetable Oil)

Is a good raw material for Cholesterol in blood. Hence to be

avoided at home. Any vegetable oil (refined or un-refined) is

good as a cooking medium except Coconut Oil & Palm Oil.

Most of the fried foods in Hotels, Restaurants, functions and

guest houses are prepared in hydrogenated vegetable oil. An

Executive traveling on company’s account has to be aware of

this fact and be choosy while ordering food out side.

Un-refined Oil is much better than refined oil; but in cities it is

impractical to procure un-adulterated.

"Any oil which solidifies at room temperature contains

saturated fats and promotes LDL (bad) Cholesterol."

II Hazardous food stuffs cont’d…

184

-are potential Carcinogens (Cancer producing).

Even permitted colors containing Tartrazine and other chemicals are not good for Health. Colors that are not permitted are even more dangerous for Health.

Hence, one has to minimize the consumption of: - Soft drinks, Jam, Jellies, Pastries, Sauce, Ketchup, tinned and packed foods, Noodles etc.

(ii) Colors, Synthetic Food additives and chemical Preservatives

Hazardous ingredients in our daily Food…..


185 List of dangerous colors ,food additives & preservatives given on Page/Slide:188-190

I. Nutritive Sweeteners:

1. Sorbitol & Fructose (known to cause acute diarrhea)

2. Aspartame: Aspartic acid, Phenylalanine

(180 times sweeter than sugar & cannot be used in baking and cooking)

II. Non-Nutritive Sweeteners:

1. Saccharin: Potential Carcinogen of Urinary

bladder as long term complication (FDA warning)

2. & 3. Sucralose & acesulfame potassium:

Highly stable and approved by FDA

(iii) Non-Sugar Sweeteners

Ref. Current Medical Diagnosis year 2000 edition

Hazardous ingredients in our daily Food…..


186

A chemical used as clouding and density

adjusting agent in soft drinks.

Toxic Effects: Carcinogenicity

In USA permissible up to 15 ppm.

In India it is banned including Ester gum.

Suitable Substitute:

Monoglycerite of esters and fatty acids.

(iv) BVO (Brominated Vegetable Oil)

Hazardous ingredients in our daily Food….. II Good dietary habits cont’d…

187

ADDITIVE

NUMBER

NAME OF THE FOOD ADDITIVE

Hyperactivity

(H)

Allergy

(A)

Cancer

(C)

102 & E102 Tartrazine (food colour) H A C

104 & E104 Quinoline Yellow (food colour) H A C

107 & E107 Yellow 2G (food colour) H A C

110 & E110 Sunset Yellow (Yellow food colour #6 H A C

122 & E122 Azorubine, Carmoisine (food colour) H A C

123 & E123 Amaranth (Red food colour #2) H A C

124 & E124 Ponceau, Brilliant Scarlet (food colour) H A C

127 & E127 Erythrosine (Red food colour #2) H A C

E128 Red 2G (Red food colour) H A C

129 & E129 Allura Red AC (food colour) H A C

E131 Patent Blue (food colour) H A C

132 & E132 Indigotine, Indigo Carmine (food colour) H A C

133 & E133 Indigotine, Indigo Carmine (food colour) H A C

151 & E151 Activated Vegetable Carbons, Brilliant Black (food colour) _ A C

154 Food Brown, Kipper Brown, Brown FK (food colour) H A C

E173 Aluminium (preservatives) _ _ C

E180 Latol Rubine, Pigment Rubine (preservatives) H A C

210 & E210 Benzoic Acid (preservatives) H A C

List of dangerous food Colors, Additives and Preservatives

188

ADDITIVE

NUMBER


Hyperactivity

(H)

Allergy

(A)

Cancer

(C)

E230 Diphenyl, Biphenyl (preservatives) _ _ C

E231 Orthophenyl Phenol (preservatives) _ _ C

E236 Formic Acid (preservative) _ _

E239 Hexamine, Hex methylene Tetramine (preservatives) _ _ C

249 & E249 Potassium Nitrate (preservative) _ A C

250 & E250 Sodium Nitrite (preservative) H A C

251 & E251 Sodium Nitrate (preservative) H _ C

310 & E310 Propyl Gallate (Synthetic Antioxidant) _ A C

320 & E320 Butylated Hydroxyanisole (BHA) (Synthetic Antioxidants) H A C

321 & E321 Butylated Hydroxytoluene (BHT) or Butylhydroxytoluene

(Synthetic Antioxidants)

H A C

407 & E407 Carrageenan (Thickening & Stabilizing Agent) _ A C

430 Polyethylene Stearate (Emulsifier) _ _ C

431 C 431 Polyxyl Stearate (Emulsifier) _ _ C

E432 –

E435

Polyoxyethylene Sorbitan Mon stearate (Emulsifiers Gelling

Stabilisers Thickeners Agents)

_ _ C

433 – 436 Polysorbate (Emulsifiers) _ _ C

466 Sodium CarboxyMethyl Cellulose _ _ C

507 & E507 Hydrochloric Acid (Hydrolyzing Enhancer & Gelatin

Production)

_ _ C


189

ADDITIVE

NUMBER


Hyperactivity

(H)

Allergy

(A)

Cancer

(C)

518 & E518 Magnesium Sulphate (Tofu Coagulant) _ _ C

553 & E553

& E553b

Talc (Anti Caking, Filling, Softener, Agent) _ _ C

620 – 625 MSG Monosodium Glutamate, Glutamic Acid, all Glutamates

(Flavour Enhancers)

_ _ C

903 & E903 Camauba Wax (used in Chewing Gums, Coating and Glazing

Agents)

_ _ C

905 & 905

a,b,c

Paraffin and Vaseline, White Mineral Oil (Solvents, Coating

and Glazing, Anti Foaming Agents, Lubricant in Chewing

Gums)

_ _ C

924 & E924 Potassium Bromate (Agent used in Bleaching Flour) _ _ C

926 Chlorine Dioxide (Bleaching Flour and Preservative Agent) _ _ C

950 & E950 Potassium Acesulphame (Sweetener) _ _ C

952 & E952 Cyclamate and Cyclamic Acid (Sweeteners) _ _ C

1202 &

E120

Insoluble Polyvinylpyrrolidone Insoluble (Stabiliser and

Clarifying Agent added to Wine, Beer, Pharmaceuticals)

_ _ C


Can reusing repeatedly Fried Oil be dangerous to Health? Cooking oil consists of glycerol esters of fatty acids. It may be derived from plants or animals and the more common frying

oils are peanut, safflower, canola oils, or animal fat. The amounts of degradation products increase with the duration of

heating at high temperatures. The toxicity of these degradation products present a health concern. Other contaminants such as

polycyclic aromatic hydrocarbons may be concentrated by prolonged heating. Some of these have been found to be potential

carcinogens.

What to look out for: * Clear golden yellow colour and a good smell are essential.

* Brown edges and dark colours are bad .Put your nose in it; go ahead, you’ll smell the difference.

190

Cooked food put in the general section of the Fridge, gets spoilt

in 8 to 12 hours even with the Fridge door closed.

The temperature range in the general section is 4° to 10° C.

The Microbiology fact is that the Bacteria can multiply at 4° & above 4°C. Re-heating of food preserved in the Fridge even to 100°C can only destroy the Bacteria but not the Chemical poison (Endotoxin) secreted by the Bacteria.

The Endotoxins are heat stable even at 100 degrees centigrade.

7. Your Fridge is not a garbage bin !

One should know what to preserve and what not to put in Fridge.


191

O

1. Milk, Curd, Butter Milk, Butter, Cheese

2. Uncooked Vegetables

3. Fruits

4. Eggs

5. Drinking Water

6. Meat in the Deep Freezer

7. Medicines

8. Alcohol

Fridge is meant for keeping...

NOTE: Cooked Food that is kept in the Deep Freezer is preserved provided there is no power cut.

Cooked food may be kept in the Fridge from morning

only till the same day evening.

Fridge cont’d…

192

8. Pressure Cooker Conventional Cooker

Everyday, Food is being sterilized at almost 120 C temperature in a

Pressure Cooker.

It is a universal fact that food cooked above 100 C, loses nutritive value.

Rice and vegetables should never be cooked under pressure.

O

O O

15 Minutes 35 Minutes Time taken

Volume remaining constant P T (Absolute Temperature)

115 – 120 C Temperature less than 100 C

Steam

O


193

10. Microwave Oven, How safe is it ?!

Indian recipes are too complicated for cooking in a Microwave Oven.

To put the expensive gadget to optimum use, there will be a tendency to have as much stale food as possible.

Anything that can heat in a few seconds to the boiling point of Water,

is shortcut method. There are no shortcuts in the maintenance of

Health.

Whether Microwave has any Health hazard, data is still awaited !!


194

11. Have the following got any role in curing diseases ?

“Methi” (Fenugreek)

Bitter gourd juice

Jamoon (Black berry)

The answer is, an emphatic "NO"

“Hydrotherapy”: Drinking 1½ to 3 Liters of water at a time early

morning.

Oil pulling: Gargling 3 table spoons of vegetable oil for

15 min early in the morning without even brushing.

Auto urine therapy.

Garlic: in reducing Cholesterol & CAD.

Diabetes. M


195

Regular

Yogic

Exercises

3


196

“No Yoga, No Peace,

Know Yoga, Know Peace”

III Regular exercises cont’d…

197

Benefits of regular Exercise

1. Improves Cardiac and Respiratory reserves.

2. Promotes new vessel formation and improves collateral

circulation in the Heart. It also improves HDL

(Good Cholesterol) levels in blood.

3. Burns Calories and lowers Blood sugar levels.

4. Movement to joints and keeps Spine flexible.

5. Improves Digestion and helps in getting rid of constipation.

6. Keeps you active throughout the day.

7. Solves the problem of Insomnia.


198

III Regular exercises cont’d……

…..

“Luxury is defined as

the amount of Lethargy

one can afford "

199

Dr Bapuji Balijepalli

Conventional Exercises

- like Walking, Jogging, Swimming, playing Games, visiting

Health clubs, Gyms, Judo, Karate, Aerobics, Yoga institutions

etc., are not possible on regular basis for today's Executives,

Professionals and Businessmen.

Reasons are: - Time constraint

- Tours

- Requires preparation

- A companion needed

Moreover (i) these exercises cannot be done for 5 to 6 days in

a week (ii) most of them lack total effect on the body i.e., No

exercise for achieving optimal spinal flexibility.


200

“Any exercise, not done for

5 to 6 days in a week has

no positive effect in

maintenance of Health”



201

Do you know that….

The Physical exertion on account of Domestic and Professional reasons cannot

be considered as sufficient exercise excepting in hard labor as in the fields or at the

construction sites.

How much we overeat and how less we exert, you will be shocked when you

see the following tables :

Each of the following Each of the following

activities Burns only 200 Calories foods gives as many as 200 Calories

12 minutes of Jogging 2 slices of plain Bread

1/2 an hour of Swimming 2 medium size Apples

1 hour of Walking 53 Peanuts

3 hours of Singing 24 oz. of Beer

4 hours of Dish washing 21/4 bottles of Soft drink

14 hours of TV watching 3 cups of Tea with Sugar

based on the extracts from : Harrison's "Principles Of Internal Medicine"


202

Criteria for an ideal Exercise regimen

Should be of short duration.

Should be feasible wherever you are: at Home, in a Hotel room

or at a Guest house.

Should not require any preparation.

Should be easy to adopt.

Should give :

Enough exertion, movements to all the Joints, keep

the Spine flexible and should have beneficial effect

on all the Vital organs including Heart and Lungs.

- And one should be able to achieve Target Heart rate i.e. 220-Age

at the peak of daily Exercise.

- Longer the duration to achieve target Heart rate, without

any discomfort, stronger and healthier is the Heart.


203

I PART 12 Posture Cyclic Exercise (4+1) - 5 mins. II PART 2 Abdominal Exercises (2+2) - 4 mins. III PART 6 Yogasanas (1+2+1+1+1+2) - 8 mins. IV PART 6 Breathing exercises (4+2) - 6 mins. V PART 1 Shavasana (2) - 2 mins. Total Time = 25 minutes “25 minutes Yoga for You” should be done in 25 minutes only.

by Dr. B. Bapuji BSc, M B B S, ND

Dr. Rani Bapuji ND

"25 Minutes Yoga for You"

Time in Minutes.

(For all the details one should refer to “25 Minutes Yoga for You” book.) Refer Slides/Pages 220 -223 for pictures of Postures


204

Majority of people these days, after crossing the age of 20, definitely have some Physical limitations and are too stiff due to sedentary life style. It is advised for those who are between 20-60 years of age that they attempt first, the Spinal exercises (Slides/Pages-214-219) for 10 minutes in the morning (any time before breakfast) and then again 10 minutes (before dinner) in the evening, twice every day for 4 to 8 weeks. If a reasonable spinal flexibility has been achieved within 8 weeks of regular effort, then only one can attempt “25 minutes Yoga for you” regimen given in this session / book, which is a “Total and an Ideal exercise”. (Please refer the exclusive book for details). Even to do 25 Minutes yoga perfectly and achieve targets given in each of the V parts, for a young man or woman, It takes 4 to 6

months of slow, gradual and everyday regular effort. It also depends on age. After the age of 60, 25 minutes yoga should not be attempted unless, one has been doing them earlier regularly for decades. Such people can manage with 45 minute of brisk walk followed by Spinal exercises and Breathing exercises to keep themselves fit physically. Keeping Spine optimally flexible is a must.

An important advice for every one, before taking up “25 Minutes Yoga for You.”


205

8 out of 10 people have either Lower Back or Neck

problem by the time they cross the age of 30.

United States of America is losing

around 50 Billion dollars annually

because of lower back and neck

problems towards man-hours lost,

consultations, tests & treatments.

This amount is three times the annual

budget of NASA which is *16 Billion

dollars, as mentioned in the media

after the unfortunate disaster of space

shuttle “Columbia”.

* Ref: Details published in the Media after the disaster of Space Shuttle - Columbia


206

NECK AND LOWER BACK ACHES- Neck and Lower back ache have become so common that 16 & 20 year young, are seeking treatment for these complaints.

• The Reasons: No physical activity, no games or workout in School &

Colleges. Reading and doing home work in lying down posture. Practically,

students do not have time for physical activity from 7 am to 9 pm in India.

Youngster are tied down to this routine, forced by Parents & Teachers.

Only academic performance is emphasized.

• Physical work, even at home is nil. This is the scenario till the students enter

profession, in India. Mothers do not teach the basics of cooking to children,

take their help in dish washing or using even Washing machine, with the

pretext of their being busy with studies and preparation for the exams.

Children are taking full advantage of this!

• Dining tables have come, Modern Gadgets have entered homes and Kitchen.

Mattresses are getting thicker, Spring cots have become status symbol, People

are watching TV lying down on bed / floor / sofas in awkward positions. In

India Servant maid washes the dishes, sweeps the house floor and swabs.

Some people can afford cooks, gardeners & Chauffer driven cars, particularly

Senior Govt. Officers, Corporate Executives, Professionals and Businessmen.


207

• Software Professionals are sitting on unsteady chairs (rollers) for

hours together, leaning back & sliding forward on the seat without the

support of foot rest under the table. Sitting posture becomes unstable.

• Press the button – garage door slides up, car door opens, TV channel

changes. Luxurious facilities in the bath and toilets are becoming

sophisticated, which need not be elaborated. Where is the physical

activity? People wait for 15 minutes at lift to go to 2nd or 3rd floor

instead of using stairs!

IMPLICATION

Neck pain / Stiffness along with Headache, shoulder pain, tingling

and numbness on the back of the Head, arms, hands, fingers, reeling

sensation, imbalance. Worst of all, if left arm pains due to Cervical

spine and Chest pain due to upper spine, can be a cause for panic of

Heart attack for everyone and patient lands up with the Cardiologist.

What can happen next, today, is anybody’s guess!

Neck & Backache cont’d….

208

Mid and Lower dorsal spine can cause - burning sensation

in the upper abdomen, Pain in the other areas of abdomen.

Patient himself goes to Gastroenterologist. One can

imagine, what goes on next. He will not be let off without

putting Endoscopic tube either from top or from below!

Lumbar spine can cause Sciatica (whole leg pain), tingling

and numbness in the legs, toes, Pain in the Knees (without

swelling) & Heels. Patient either seeks the advice of

Neurologist or of the Orthopedic Surgeon.

Multiple joint pains without swelling or inflammation

(Arthralgia) are mostly due to stiffness of Spine and

Rheumatologist has a wild goose chase in these cases. The

patient is subjected to all unnecessary and expensive tests

and prescribed pain killers, Steroids, or Methotrexate.

Neck & Backache cont’d…

209

Spinal Flexibility is highly essential, particularly as the age progresses

after 20. Hence, the Spinal exercises given on the Slides- 211-216

are mandatory for every one.

Whatever exercises one does or plays Games etc., One has to do Spinal

Exercises to keep Spine optimally flexible.

Mattress should not be more than 2 inches thick, preferably cotton on

hard surface. Pillow should be sufficiently thick 3 to 5 inches to support

the neck from shoulder tip to the side of the neck. And always sleep on

the Side as shown below (left or right does not make any difference)

One should note the following in Spinal Pains

Neck & Backache cont’d…

210

Neck should be horizontal

Surgery in Back & Neck pain is indicated only when:

• Unbearable pain continuously for more than 15 days, not relieved by rest in any position, including total bed rest for a week. Medication, Physiotherapy do not give any relief and the MRI shows relevant specific signs tallying with the symptoms.

• Progressively worsening Motor deficit i.e., creeping weakness upwards, in the muscles- Hand grip, forearm and arm due to Cervical nerve compression.

• Not able to lift the foot when tries to stand on the toes and heels. Not able to lift leg while climbing up steps due to Lumbar nerve root compression. Sudden urine retention (not passing urine) after ruling out Urinary tract Infection, Prostate enlargement or both.

• Surgery always has to be taken up by a Competent, Senior Neurosurgeon & experienced in spinal surgeries. Not an Orthopedic Surgeon.

• Numbness in arms or legs is not the indication for surgery at all irrespective of MRI finding. Results of Spinal surgery are not without serious complications, most of the times.

• In USA the incidence of Spinal surgery is- . 06%. That too, the Surgeon

would inform and take consent for all the possible complications later, including Paralysis, loss of urine and Bowel control.

Neck & Backache cont’d….

211

.

10 Minutes Spinal Exercises for Elders (60+) For symptomatic relief of spinal root pains (neck & lower back in particular)

1

22

23

24

Arms close to the body, feet and knees 1 foot

apart. Try to lift hips and waist as high as

possible. Need not hold the final position.

6 times.

Palms under the head & elbows down on the surface.

Fold the legs at the knees with feet together. Now, allow

the knees to fall to the right on to the surface with left

knee over the right knee, simultaneously turn the face to the

left to look towards left elbow and vice versa.

6 times alternating.

Feet together, Palms on the surface by the side of chest

fingers not crossing the shoulder point & chin on the

surface. Lift up Head, neck & chest up to the level of

naval & look at the ceiling with elbows close to the body

and feet together. Only once try to hold for ½ a minute.

Lie down prone, chin on the surface, arms straight

under the abdomen, palms under the thighs & feet

together. Lift up one leg at a time as high as possible

keeping the knee straight, alternating with the other.

3 times each leg.


212

10 Minutes Spinal Exercises for Elders cont’d…

Sitting on a stool.

Each exercise 6 times, each side alternating with the other, no rest in between.

i

Bend head forwards & backwards

(less forward & more backwards).

Keep the spine straight.

ii

Tilt the head to the side towards

the shoulder as much as possible

keeping the face to the front.

Then to the other side.

Turn the head from one

shoulder to the other and

try to look behind.

iii

Note:

After each spinal exercise, ½ a minute rest is mandatory either lying down supine or prone during the

Spinal exercises given on the previous slide. No rest is needed between the neck exercises. Spinal &

Neck exercises have to be done morning before breakfast & again before dinner, twice a day.


213

1.

Spinal Exercises (for young and middle aged)

Lie down flat on the back with arms

stretched close to the body, palms facing

down. Feet & knees one foot apart.

Lift up hips & waist as much as possible.

Bring the hips & waist down.

Repeat 6 times.


214

Lie down flat on the back, arms perpendicular to

the body, palms facing down & feet together.

Spinal Exercises cont’d….

Now bring the left leg to the right simultaneously

turning the head to the opposite side in the same

way as you have done above.

6 times alternating with the other.

Lift up the right leg up to 45 degrees and take it to

the opposite side to touch the great toe to the

ground (creating an angle of 90 degrees). Knees

to be kept straight. Simultaneously turn your head

to the right to look towards right hand. Get back to

the original position the same way you have done.

2.


215


Lie down on the abdomen, chin on the

floor, palms by the side and close to

the chest & feet together. Keep the

Elbows close to the body.

Lift up the Head & Chest to look towards

the ceiling above the head, with elbows

close to the body & feet together. Hold on

to the position for ½ a minute and then

relax, Only once.

3.


216

Lie down on the abdomen, chin on the floor, feet

together. Put your Palms under the thighs with

elbows straight and under the tummy.

a.

b.

Lift right leg as high as possible with both the knees straight and bring it down.

3 times with each leg alternating with the other.

Lift up both the legs together with knees straight and hold the position

for ½ a minute. Only once.

Spinal Exercises cont’d…. 4.


217

Lie down on the abdomen, fold the legs, hold them with the respective hands at the

lower end of the leg with thumb along with the other fingers. Spread the knees and

feet 1 foot apart.

Lift up the head and chest to look towards the ceiling simultaneously pushing both the

legs backwards.

Hold on the posture for ½ a minute. Only once.

5.



218

Neck Exercises

1. 2.

3.

Bend your head Less forward & more

backward, 6 times each alternating with

the other.

Tilt your head to the side keeping the

face in front, 6 times each side

alternating with the other.

Turn your head to the side to look behind & come back to the original position.

Then turn to the other side, 6 times alternating with each side.

Note: Neck exercises can be done sitting in a chair / Stool with the back straight not

leaning on to the back rest of the chair for those young adults not able to squat.


219

12 Posture cyclic exercise

Part I

Starting Pose

Age-wise rate of doing in 4 minutes

15 cycles 35 years & below

10 cycles 36 to 50 years

6 cycles 51 and above

2

3

4

1 12

5

9

6

11

10

7

8


"25 Minutes Yoga for You"

220

(4 minutes + 1 minute rest)

Exercise I

Target- 20 times at a stretch each of the two exercises in 1 ½ minutes followed by ½minute rest in between the

two exercises.

Part II : 2 Abdominal Exercises (4 minutes)

Exercise II

25 Minutes Yoga cont’d…

221

Paschimothanasana

½ mts.+ ½ mts. rest Sarvangasana

2 mts. + ½ mts. rest

Padmasana ½ mts. + ½ mts.

rest

Bhujangasana ½ mts. + ½ mts. rest

Dhanurasana ½ mts. + ½ mts. rest

Ardhamatsyandrasana ½ mt. + ½ mt. + ½ mt. rest

Part III 6 Yogasanas (8 minutes including half a minute rest in between)

Wall 2 ft.


222

Part IV Breathing Exercises (6 minutes)

Part V Shavasana 2 minutes

Posture for

exercises 1,2,5 & 6

Posture for

exercises 3 & 4

Three deep breathing Exercises – 4 minutes.

Three brisk breathing Exercises - 2 minutes.

1 2 3

4 5 6

Breathe in, slowly as long as you can, 7-8 seconds

breathe out slowly (6 times each exercise)

Breathe in, and Breathe out briskly, forcefully and

noisily in a rhythmic manner

(1/2 minute each exercise)


223


Avoiding

Excessive

Indiscriminate

Medication

4

224

Harmful effects of indiscriminate Medication

1. Lowers individual resistance

2. Drugs themselves can induce Diseases like:

Reflux Esophagitis, Gastritis, Duodenal Ulcer,

Diabetes.M, Hypertension, Heart attack &

Strokes due to thrombosis in most unlikely

people, Migraine, Skin Allergies, premature

Cataract, Auto-immune diseases, loss of libido,

impotency and even Cancer.

3. Kidney and Liver failure.

4. Results in evolution of Superbug

(“Clostridium difficile”)

A.

IV Indiscriminate medication cont’d…

225

B. Drug situation in India - Pathetic

- Manner in which 10 - 16 Medicines prescribed by

Consultants, even for minor problems.

- Costlier the drug, more chances of being spurious.

- Spurious and sub-standard Medication in bulk

supply to all Nursing Homes, Corporate hospitals

and even Government Hospitals. It is an open

secret. 60% - 80% Drugs are spurious in the open

market particularly expensive ones.

- Banned Drugs are still prescribed and sold.

- Mammoth number of formulations licensed for

manufacture…

IV Drug situation in India cont’d…

226

The WHO Model List of Essential Medicines is a list of

over *350 generic names of medicines.

Bangladesh is managing today with only 170

formulations.

According to the “Hathi committee" report appointed by

Govt. of India some years ago, 117 generic drugs are

enough for Primary Health Care in India.


227 *Fact sheet No.325, Revised June, 2010 http://www.who.int/mediacentre/factsheets/fs325/en/index.html

There are about 1,70,000 combination drugs unfortunately, in Indian

market and 80% of these drugs are -

Inessential

Irrational

Harmful and drugs of

Doubtful efficacy

`80,000 Crores per annum is the financial turnover of

pharmaceutical Industry in India, and unless Prime Minister takes

initiative, this situation cannot be corrected during our life time.

This situation will never be corrected during our lifetime, as none of

the present and future Prime Ministers of our country will ever dare to

meddle with this Hornet's Nest. They have enough of other problems

on their heads including their own survival with the support and

mercy of belligerent coalition political parties.


228

http://www.clipartguide.com/_pages/0060-0610-2515-0414.html

It is impossible to do research or can ever be done about drug interaction between various drugs when 1,70,000 combination drugs are for sale today in India and the number is ever increasing.

When 8-16 types of medication three times a day taken by a patient in a day (prescribed by various specialists) meet in the stomach, in blood, in Liver or in Kidneys- What happens, no body knows.

Mix- 1 cup of coffee+1cup of grape juice+add 1 table spoon of anchovy sauce+1 cup of Yogurt+100 ml of Cola +1cup of porridge + 2 pegs of Whisky.

Will the above mixture taste good or bad, whether it will be beneficial or harmful? It could be fatal who knows !


229

Hence dictum should be to

manage with as minimum

medication as possible and avoid

taking multiple medication

together.

Note : Margin of error is very small in elders and in small

Children < 5 years of age, that too when multiple drugs are

given, sometimes it can result in premature fatal outcome.


230


“Every Pill has an ill”

Under these circumstances somebody rightly said:

“Consult the Doctor, pay his fee so that he can make his living ! Take the Doctor's prescription to the pharmacist, buy the Medicines, for he has to live ! Bring the Medicines home, throw them away, for You too have to survive !!"


231

“We are putting Medicines

of which we know less;

into the bodies of which we

know Least!”



232

Factors that preserve and restore Health...

Abstaining from:

- Excess Tea / Coffee

- Smoking

- Tobacco products

- Narcotic Drugs

- Excess Alcohol

5

233

1. Excess Tea / Coffee

Anything more than 2 or 3 cups /day,

is considered as excess.

Excess Tea / Coffee can cause: Acidity,

Duodenal Ulcer, loss of appetite due to

sluggish liver, disrupts dietary schedule

and also can cause missed heart beats.

V Habits & addictions cont’d…

234

2. Smoking / Tobacco products can induce:

i. Coronary Spasm & Heart attack.(It can happen without blocks)

ii. Promotes Cholesterol & its deposition in the blood

vessels.

Note: There is no difference between 1 & 40 cigarettes/day

as far as Heart attack is concerned.

iii. Throat & Lung cancers have limited options even in

Modern medicine anywhere in the World.

235


3. Pan Masalas (mouth fresheners)

are potential Carcinogens (Cancer producing)

4. Narcotic Drugs

- It takes only two days to get addicted to a Narcotic drug.

- And it takes months of institutional treatment with lot of

expenditure to cure a Drug addict with 95% failure rate.

236


To give up an addiction

Remember, an addiction can never be given up gradually. it has to be stopped totally and abruptly. When it is stopped suddenly, withdrawal symptoms like- Moody, restlessness, irritability, irrational behavior, sleeplessness etc., develop.

Remaining on Liquid diet for three days helps in reducing the withdrawal symptoms. Take Family Physician’s or Psychiatrist’s help in having a sedative or tranquilizer for sleeplessness.

One has to make up one's mind before attempting total abstinence. Co-operation of family members and Friends is highly essential in encouraging abstinence and overcome temptation.

237


Two limits of Alcohol

2. Drink like fish every Saturday evening / only once a Week.

Those who do not drink and

those who do not drink daily,

need not start or need not drink

everyday. The above prescribed

limit is the upper limit.

1. Two small (30 ml) pegs of Whisky or 1 Bottle

(640 ml) of Beer / everyday.

Or

238


Alcohol and its relationship to Liver and other serious diseases

1. One who drinks regularly (2-3 times a week), has to eat high protein

diet (chicken, eggs, meat etc.,). Otherwise liver gets damaged,. and if

one eats high protein diet (with high content of spices and oil like in

India), one is going to develop:

* Obesity, high Cholesterol, High blood pressure,

Coronary Artery Disease, Diabetes etc.,

Between the Deep Sea and the Devil, the Choice Becomes Difficult !!

2. Diabetes and alcohol can never go together !!

3. Limited Alcohol may be good for Heart from medical point of view,

but.. How many people can stick to the safe limits of it ?

239


But, remember

only

1 in 1000

can stick to the limits

of Alcohol specified!

240


Factor that preserves and restores Health... ￩ Go to Index

The Philosophy of Life

I received Nothing I wanted, I received Everything I needed.

and God gave me

opportunities.

I asked for

Strength

and God gave me difficulties to

make me Strong.

I asked for

wisdom

and God gave me

problems to Solve.

I asked for

prosperity

and God gave me Brain and

brawn to work.

I asked for

courage

and God gave me

danger to overcome.

I asked

for love and God gave me troubled

people to help.

I asked for

favours

6

VI a Philosophical approach

241

http://www.firstpeople.us/FP-Html-Pictures/eagle_pg1.html

Summing up on Health & Stress Management Life style management is the only way out for a reasonable Health.

Doctor & Patient relationship – there is a communication gap resulting in mistrust.

Population ageing and problems of Elders- Even rich countries are not able to manage.

Commercialization and unethical Practice in medical field is the order of the day. This is taking

toll of the patients and the entire family in developing countries.

Hippocratic oath has gone into oblivion- adding to the Physical and mental Stress of the Patient.

Physical Health has a lot of bearing on Mental stress.

To live is not sufficient; we need also the joy of living; which definitely depends on Health.

Human body is very complicated; its maintenance is the wisest thing.

Medical field has become highly commercialized and unethical like any other field, about which

one can do nothing. Physician’s Conscience is the only way, it can get corrected. The Patients

can only hope and pray for it in the future.

A reasonable Health all of us have to aspire for and make an effort as it is not a purchasable

commodity.

Family Physician and Company Doctor has a crucial role to play in helping us.

Pessimistic approach of today’s educated patient and his ignorance & misconceptions.

Mental Health Depends on…….

Moral & Ethical values

Professional & Domestic Commitment,

Contentment,

Positive approach and Shedding ego 242

* LET US AGE GRACEFULLY. Dr. Bapuji Balijepalli

For Physical Health…

Remain on suitable Liquid Diet for a few to 48 hours when not well and then see the Family

Physician or Company Doctor in all day to day ailments.

Pregnant women to take care of certain precautions in first three months of conception to avoid

Birth Defects in New Born.

People with Hereditary tendency of Diabetes, High blood pressure & Heart attacks have to take

certain precautions right from early age.

There are certain Foods that have bearing in Allergic problems and in Autoimmune diseases.

Dangerous food additives a cause for increase in the incidence of Cancer.

Proper Diabetic management, Proper insulin administration, No thyroid medication based on TSH.

Obesity is a disease. Not a sign of prosperity. Exercises can not reduce weight as they have to be

done 4 hours a day which is not practical for most of the people. Dieting is the only alternative.

Assess your own Health periodically.

Annual checkup for couples who have crossed 30.

Factors that Preserve our Health and restore happiness to be always remembered and followed:

- Regulated daily routine

- Good dietary habits

- Regular yogic exercise

- Avoid indiscriminate medication,

- Get rid of habits and addictions

- Philosophical approach to Life 243

The Purpose of the

whole session, is to achieve..

that is ...

The objective…

244

The objective…

Having been born,

all of us have to

"go" someday !

but…

245

Let us age gracefully,

breathe last

without pain and

suffering,

and not become

pathetically dependent on

anybody for our

day to day needs.

At the twilight of our life…

246 246

Hope,

the points

could be put

across.

247

Thank you very much for all the Patience you have shown for

this Marathon session.

Dr. Bapuji Balijepalli 248

From “Bhagvatham”

249

￩ Go to Index ￩ Go to Index ￩ Go to Index

Dr.Bapuji Balijepalli, was born on 12th July, 1950 in a family of Doctors and Naturopaths. He is the First graduate of Modern Medicine to have taken up Naturopathy as his career, in India. He has given a scientific approach to the system of Naturopathy, specifying its Scope and Limitation. His approach of practice is an integrated one in the best interest of people in restoration of Health. Presently, he is the Managing Director and Consultant at Nature Cure Health Care Center, Kantisikhara, Punjagutta, Hyderabad-500 082.

About the Faculty…

He has been a Visiting / Guest Faculty to some of the following very prestigious institutions on the subject of “Executive Health & Stress management” and the sessions have been rated Excellent in the content and as well as in the mode of presentation.

*He delivered a Keynote speech in 8th Global conference, invited and organized by International federation on ageing in Copenhagen on 1st June 2006, wherein 1000 delegates from 62 Countries attended. His session was overwhelmingly received with appreciation and moved everyone.

Administrative Staff College of India (ASCI), Engineering Staff College of India (ESCI), National Police Academy (NPA), Jawaharlal Nehru Institute of Development Banking (JNIDB), Center for Organizational Development (COD), State Bank Staff Training College, Life Insurance Corporation of India (LIC), College of Insurance and Financial Planning (CIFA) National Industrial Security Academy (NISA), Tata group of Industries, Indian Oil Corporation Limited (IOCL) Bharat Heavy Electricals Limited (BHEL), National Aluminum company Limited (NALCO), Power Grid Corporation, National Thermal Power Corporation (NTPC), Saint Gobain Ltd, Indian Institute of Chemical Technology (IICT), and many other social organizations and institutions…. 250

Former Dean, Faculty of Indian Medicine (Naturopathy), University of Health Sciences, Government of A.P. He was also Superintendent of Nature Cure Hospital, Begumpet, Hyderabad, a 150 - bedded, largest and the oldest institution in India, during 1980-1990. He held full additional charge as Principal of Gandhi Nature Cure College, Hyderabad, between 1985-1987, the first college conducting a University recognized Degree Course in Naturopathy. He was also Consultant to Nagarjuna group of Industries and TCI during the period 1982-2005. He was a keen Flier and the only one out of the 9 Cadets of the batch who had done SOLO FLYING on Pushpak Aircraft in 1970 within 17 hours of training, while in National Cadet Corps. He is proficient in English, Hindi and Telugu. His hobby is Instrumental Music – Sitar (Hindustani) Family: Hails from the family of Medical professionals both from the Traditional & Alternative Systems. Parents- Dr Venkat Rao and Dr Vijayalkshmi were renowned Naturopaths of India. Wife Dr Rani ND has chosen to be a home maker after 25 years of domestic and Professional work, Younger brother Dr Shivaji MBBS, ND pursuing his career like him in Hyderabad, Youngest brother Bali Netaji MD, is a well known Medical Oncologist in Austin, USA. Daughter Lavanya (1983 born) is an MBA and a manager in MNC. Son Dr Aditya (1985 born) has taken up father’s mission and is a duly qualified Physician after acquiring MBBS, completed post graduate diploma in Family Medicine (RCGP) and is assisting his Father in practising Integrated Medicine to continue the legacy. Dr Bapuji was initiated into Public Speaking & Training by Late Sri KVK Raju, Founder of Nagarjuna Group, who was and continues to be his Friend, Guide & Philosopher.

About the Faculty…

251

For further details

Contact -

Dr. B. Bapuji / Dr. Aditya Bapuji

Nature Cure Health Care Centre,

Kantisikhara, Punjagutta, Hyderabad-500 082, India

Telephone : 91-40- 23418307, 23400601 & 66627212 Timings: 8.30 a.m.---1.00 noon.

4.00 p.m.--- 8.30 p.m.

Cell: +91- 9848096334, +91-9000598022

email: [email protected]

email: [email protected]

Website: www.naturecurehealthcare.com & www.drbapuji.com

Copyright 2004. © Dr. Bapuji Balijepalli. All rights reserved. 252












Requirements:

An effective presentation can be made in a good A/C hall with Screen, Collar Mike, LCD, CPU & Key

Board should be made available by the Organizers for PowerPoint presentation (Windows 2007). The

lecture session can be organized as Pre-lunch 9:00 am to 1:30 pm, Post-lunch 2:00 pm to 6:30 pm or

Pre-dinner 5 pm to 9:30 pm with 30 to 60 participants (Couples would be ideal, No Children please.)

For all Outstation Sessions within India, the Professional fee charged for 4 hour Program, has to be

fixed by e mail by the competent authority of the inviting Organization after contacting Dr B Bapuji. The

Professional fee is payable immediately after the session is over through Cashier’s Cheque, Demand

draft or Banker's Cheque drawn in favor of Dr. B. Bapuji payable in Hyderabad. Programs in

Hyderabad, the competent authority of the organization can contact on Phone and work out the dates

of mutual convenience and also fix up the Professional fee , payable as mentioned above.

For holding sessions out of India - US $ 5000 by Demand draft drawn in favor of Dr. B. Bapuji

payable in Hyderabad, INDIA. Amount can also be transferred electronically to Dr. B. Bapuji's bank

account details of which will be provided on request.

For all outstation Programs, apart from the Professional fee which is variable (to meet the opportunity

costs, based on how long Dr. Bapuji has to be away from Hyderabad), air travel, local transport,

accommodation & incidental expenses have to be borne by the inviting Company/Organization.

Government Sector, Public Sector or Corporate Sector undertakings organizing the presentation, have

to fix up the dates at least one month in advance.

To Organize this 4 hour (half a day) session…

Dr. B. BAPUJI, Managing Director Nature Cure Health Care Center, Kantisikhara,

Hyderabad, 500 016, India. Date: 12th January 2012 Mobile: 91 98480 96334 [email protected]

253


Contents in this book do not suggest specific treatment for diseases. The effort has been to provide

educational information related to Health and Stress management based on Naturopathy, Yoga and

Modern medicine (Traditional medicine in west). The effort is to educate people in prevention of

common day to day ailments and some of the common chronic diseases. For better understanding of

their health problems and for specific advice of their diagnosed and undiagnosed health problems, it is

advised that people may contact their Physician or the author of this book with all the relevant details.

Disclaimer

Acknowledgement

254

Author expresses profound thanks to persons who have put Photographs of individuals and Cartoons

in the web that were downloaded though Google for incorporating in this presentation, to impress

upon the readers for a better understanding and healthy living. Author is indebted to all the

academicians, particularly Prof. K S Ramesh, former Dean of ASCI, for refining the contents of the

Book. Mr N Amrthesh and his staff of VenChars Media Communication Pvt Ltd, to help in software

support and designing in bringing out the format of this presentation. It is to be mentioned here that

Mr P Narendra, of Pragati offset Pvt Ltd has gracefully obliged to print this book to meet the

international standard.

Last but not the least, contributions from my son Dr Aditya Bapuji , who has finished regular Medical

course of MBBS and has done post graduate Diploma in Family Medicine and assisting me in my

practice to continue the legacy of integrated Practice of Medicine. I owe a great deal to all other

friends and well wishers who gave their inputs for this book.