Today I wheezed, today I sneezed,
Today I learned a lesson.
That breathing in and out each day
Is really quite a blessing.
Some tubes connect my mouth to my lungs,
And at times they swell up like a balloon.
And when they do, the air squeaks through,
So my breathing appears out of tune.
This swelling occurs when I pat the dog,
Or run out in the cold.
When grass is cut, or leaves are raked,
Or when there’s lots of mold.
I’m absent when the tubes swell tight.
Some say I’m playing hooky,
But when breathing is a struggle,
I can’t even eat a cookie.
I’ve learned what I’ve got is called asthma.
It’s a good thing for me that I’m bright.
I test my breathing at the start of each day,
And avoid things that make the tubes tight.
The dog sleeps in the basement.
I keep my stuffed toys clean.
No one’s allowed to smoke inside,
Hope you don’t think that’s mean.
Sometimes no matter what I do
The tubes swell anyhow,
But I have tricks tucked up my sleeve.
I’ll share some with you now.
I puff special medicine into my mouth
With a nebulizer gadget.
It works to open up the tubes.
It really is like magic.
Before I play some basketball
Or run out in the rain,
I puff a different medicine.
Then I can join the game.
I don’t eat many junk foods,
And I try hard not to whine.
These tricks help me stay healthy,
So most times I’m just fine.
If breathing in and breathing out,
A zillion times each and every day.
Is something you do without a thought,
Thank God for this gift when you pray.
- Dr.R.Ravindranath
Waiting to see the consultant as an outpatient
Minutes move by and hours pass by making you impatient
One comes out as other goes in, still how many patients?
Even as your heart harps, mind admires the physician’s patience.
As your turn comes and, you see the intern
“How long have you had this?”, he asks with concern
And proceeds to probe all your deeds and ‘miss’ deed
From what you eat to where you slept, only to help you indeed!
He hears the lung’s lullaby and heart’s hustling with stethoscope
Sees you eye to eye, deep into the eye with ophthalmoscope
Even as he takes off his white robe
Says He ‘You are infested with a terrible microbe’.
“Call Mary”, orders the medic, “Feel his pulse”
Feels sorry the patient, failing to check his impulse
Acute as he is, with all his body heat
Cute as she is, measures him in Fahrenheit.
“Gulp this” says the girlie, handing over a tab of paracetamol
“Help yourself as I rub the swab of alcohol!”
As the millies from the vial being syringed
Your sinews, feel your milieu being infringed.
“Will I be all right?”, you ask your illness course
Wondering whimsically what has brought this curse
“Don’t worry, be happy” , consoles the nice nurse
Swells your heart with hope, even as your fingers feel a thinner purse.
When one gets ill
He goes to the doctor to have some pill
If he gets well, he pays the bill
Or out of sight, having left his will!
Origin
PA said “No more pleasure to gain, than to relieve somebody in pain
Of all professions, none is nobler than the one who makes the disabled able again
Even Ma nods, “Next to god none else serves the sad one”
So also thought I, and acted to become one.
Education
Eleven to twelve years, many finish their education
Seven to eleven years, again to complete medication
Greek and Latin to decipher, papers to present and volumes to study
Takes another decade to become steady.
First Posting
Peanuts, they pay for many a sleepless night away
‘Noble Profession’, powerful politicians talk off the talk of pay
Drugless Dispensaries, day and night, what to dispense?
Only spiritless workers, with ‘spirits’ at exchequer’s expense.
Night Call
‘Doctor Doctor!!’, a restless patient knock at the dead of night
Little he cares about the resting physician’s plight
“I didn’t have time, had to see off friends in the weekend”
The beach and the movies have left him weakened.
In the Hospital
As you see the medic with a sea of troubles
Expect him to give a magical cure to see off all his troubles
Only the doctor knows the diseases he has so many
Even half of them can’t be cured with all his money.
Chamber
As I analyze umpteen symptoms and systemic signs
He asks me to detail the treatment designs
Even before I say we are in the site of diagnosis
Eagerly he asks, “What is the prognosis?”
In the ICU
As the fingers crossed, I wonders, “What is the GOD’s will ?”
One of the relatives asks, “Should we prepare his will 7’
When I say for all his ills, there is no panacea
Another one asks, “What do you think of euthanasia?”
Billing
“You are the GOD in Human form, saving me from all bother,
From deathbed thee brought back in good stead, my father.
What can I do for you? “asks he, Say I, “Pay only my fee”.
“What can I do? “(change tone), again asks he, as if I fleece.
The Ultimate
With trauma you see the experienced surgeon, who sewed the tissues intact
Traumatic experiences, he gets, being sued for non issues, in fact.
Let not the people shower praises, in abundance, as their gratitude
Enough if ‘sense’ prevails over ‘nonsense’ to change their attitude.
- Dr.R.Ravindranath
People with asthma can take an active role in controlling their disease by identifying and reducing exposure to those factors that increase symptoms or cause asthma attacks. For example, if allergies trigger your asthma, being aware of those allergies and avoid them to significantly reduce the frequency or severity of asthma attacks.
What Are the Most Common Asthma Triggers?
- Upper respiratory infections. Cold and flu, bronchitis (infection of the large airways), or sinus infections can cause an asthma attack.
- Inhaled allergens. Eighty percent of people with asthma have allergies to airborne substances such as tree, grass and weed pollens, mold, animal dander, dust mites and cockroach particles.
- Medications. Many people with asthma are sensitive to aspirin and other anti-inflammatory drugs like ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), ketoprofen (Orudis) and beta-blockers (used to prevent migraine headaches and treat heart disease, high blood pressure and glaucoma).
- Food and food additives. Certain foods contain substances that can trigger asthma symptoms.
- Exercise. Strenuous exercise can cause a narrowing of the airways in about 80% of people with asthma.
- Irritants. Many irritants, including tobacco smoke, smoke from wood-burning appliances or fireplaces, strong odors from perfumes, and cleaning agents, etc., are all irritants that can trigger asthma. In addition, air pollution, occupational dust or vapors can also trigger an attack.
- Weather. Cold air, changes in temperature and humidity can cause asthma.
- Strong emotions. Anxiety, crying, yelling, stress, anger or laughing hard can trigger an attack.
- Gastroesophageal reflux disease (GERD).
In people with asthma, the airways are always inflamed and very sensitive, so they react to a variety of external factors, or "triggers." Coming into contact with these triggers is what causes the airways to tighten, increase inflammation and become blocked with mucus, resulting in breathing problems, asthma, or worsening of asthma symptoms. An asthma attack can begin immediately after exposure to a trigger or several days or even weeks later.
There are many kinds of triggers. Reactions to them are different for each person and vary from time to time. Certain triggers may be harmless to some people but contribute to inflammation in others. Some people have many triggers while others have no identifiable ones. Recognizing and avoiding these triggers, when possible, is an important way to control asthma. Keep in mind, however, that the best way to control it is with asthma medicines.
How Do I Recognize What Triggers My Asthma?
Determining what factors were present when your asthma symptoms started is the first step to recognizing your asthma triggers. Although there are many different triggers, you may not react to all of them. Some people have only one trigger, while others have many.
Many asthma triggers can be identified through a history of reaction and skin or blood testing. Your doctor may also recommend using a device called a peak flow meter. The peak flow meter measures how much and how quickly air is exhaled from the lungs. It can alert you to changes in your breathing and the onset of asthma symptoms, triggered by an allergen.
Ask your doctor or asthma care provider if using a peak flow meter would be helpful to you. Read the rest of the story >>
An apple a day keeps the doctor away
A garlic a day keeps everybody away
“A peg or two a day keeps heart disease at bay”
Say even some Medics, why not I celebrate everyday?
They say, success in life comes to a workaholic
Does it matter if it spells a little differently, murmurs an alcoholic
Don’t they know, it elevates even a melancholic
Why the hue and cry, which is only symbolic.
It kindles the desire, but takes away the performance
With the boom of Viagra, should one worry about differvescence?
Seldom one ponders over sayings of Shakespeare
When settling their scores with spirits as it shakes the peer.
Scotland yard is the best yard by yard says even mum
When Scot’s product is taken only by measures, why this conundrum
You allow an Analgin, but if I take it’s analogy (a rose is a rose by any name) gin
Or rum or Whisky, why I am whisked away !
Medic may say excess of it produces hemorrhages,
Does he say, even little indulgence leads to cirrhosis
Even though it may cause a little pyrosis
Can you deny yourself and ration your gyrations.
Taking even a cup of wine
Makes me feel so fine
Let not the pleasure be only mine
Get it and take a measure to make it thine.
When it is a Panacea, taking away your inhibitions
Why they police with policies of punitive prohibitions
May not if they only experience its’ qualitative exhibition
As it is my time to vend again, herewith I stop my rendition.
- Dr.R.Ravindranath
A wise doctor or a nice nurse use it only as a swab
Only the nervous and feeble minded prepare their stony tab
Even a Martini, if any, like not I, as I am full of spirits
Let it be in the bowl and bowel of the dispirited.
Slowly slipping, sinking into the grip of Saturn’s sight
Salty sayings and peppery peeps ending in drunken brawls
Driving drunken is like dating to join the devil’s haul.
Nor starved stomach know what he ate
As it is not a common scene, or a mere matter of anemia
Casual drinkers landing in casualty with hypoglycemia.
Want to be breathless with bewildering sigh of cardiac myopathia?
Restless days with peripheral neuritis
Sleepless nights with perennial pruritis.
Even a Casanova may not like to adorn with gynacomasitia
The strongest swaying with cerebral atoxia
Palmar, Erythema and Cutaneous Purpura are not the only cooing signs
Spider naevi leaving cutaneous cartography of the devil’s designs.
Atropic gastritis or anaemia so pernicious
May be corrected with diet if nutritious
Well he may not become, once well into the Wernickes encephalopathy
Wisdom is not the word of Confucius, with Karsakoff’s psychopathy.
Veins over the abdomen unveil as ‘caput medussae’ , in serpentine matrices
Even as its’ counterpart in its core, ever threatening to burst esophageal varices
If you don’t put a full stop, comma, or at least an apostrophe,
The drama may end as a traumatic catastrophe.
The ultras sound a faint, fatty liver
Hemograms suggest an impending hemorrhagic shiver
Even as the CATscan cry on the closed hoses of cirrhosis
Hi tardy! Jeopardy heralds the day with jaundice so yellowish.
Even as it elevates healthy HDL, so also the lethal LDL
Odd is the evolution, yelling that the solution is not so ideal
The euphoric high of the inebriate ephemeric and unreal
Utopian he thinks, utterly failing to visualize the real.
Don’t you know, no sensible doctor ever kills or prolongs the disease
As longer he lives, the more he collects his fees
You take wine, wine takes wine and wine takes you
So Romans, Romeos and friends, it is time for adieu!!
Asthma, Basedow*, Cholesterol and Diabetes
Topics including these, with a take on Professional fees
Are given in this book in a capsule form
To calm your nerves, like Chloroform.
Kargil and Cyclone are not kept out either
Like Jejunum after Duodenum, one follows the other
Enemies of mankind - be they men, monster or microbes
Are discussed in verse form after several probes.
While the author may or may not be agnostic
He certainly is very diagnostic
The soul of the patients is laid very bare
But the words have been chosen with great care.
In extending the hand with a healing touch
One understands why he is sought after much
‘Doctor in verse, is it for the better or worse?
It’s all for the soul and essentially to nurse.
A Medico scribbling poetry while on call
Is not a strange thing mate; for his name says it all.
- Dr.R.Ravindranath
____________________________________________
* Basedow- Exopthalmic goiter
**Jejunum The section of the small bowel that follows duodenum
Query:
Dear Sir
I got your email and contact via your blog. I am writing to you from Mumbai, and the query is regarding severe pain in the soles of my father Mr. Pankaj Pandya
Currently he is taking Glycomet GP 2 for his diabetes, and is on a relatively modest diet. Plus has hyper tension as well.
His blood sugar levels keep fluctuating from 130-170 (fasting) and 170-220 (post food). However despite the medicines and rest, he suffers from severe pain in both his feet, especially his soles.
The pain is of a constant burning sensation and cramps, which makes it difficult for him to walk or even stand for a short duration. Despite wearing comfortable soft cushioned foot ever, the problem still continues.
I would request you to kindly give your suggestions on the possible causes, and the remedies. And if you have a branch or centre in Mumbai - then we could go there with the detailed reports.
Thanks and regards
Sagar Pandya
Answer:
Good Evening Mr.Pandya,
The sole-stirring problems of your "sweet" father may be due to Diabetes itself causing peripheral vascular disease, compromising blood circulation or Diabetic Neuropathy. The other causes may be Thyroid deficiency, Raynaud's disease, Calcanial Spur to mention a few among the possibilities.
He may need a better control of his Diabetes, Hypertension, PVD, Quitting Smoking (if he smokes) with proper lifestyle changes. He may need a test for Neuropathy (Bio-Thesiometry), Circulation, Vascular Doppler, Vascular Profile (VP) test (read my article), and even angiography. Please consult your Physician for further instructions.
yours truly,
Dr.Ravindranath
Why to die young when you can die of ripe old age?
Those of you familiar with Indian literature must have heard of Tenali Raman the prodigal court jester of King Krishnadevaraya and his wit. The story goes that once when he was sentenced to die and asked to choose his own mode of death, he wisely chose to die of ‘Old Age’ and his presence of mind saved his life. Yes, indeed most humans would prefer to die of old age than any other mode. That is if they escape the number one killer that is ‘Heart disease and stroke’ that claims 17.5 million lives each year. Heart disease and stroke kills more women each year than cancer, tuberculosis, HIV/AIDS and malaria combined. One more co-morbidity is diabetes in which the risk of cardiovascular morbidity is 3 to 4 times more. With advances in medicine, however, it is now possible to detect your risk for heart diseases well in advance to actually prevent them. In this article get introduced to a new test, a non-invasive, economical, efficient and speedy option called, ‘Vascular Profiler test’ that has come forth as the primary choice among the armamentarium of investigations available, for detecting Cardiovascular diseases.
THE FUNDAMENTALS
In healthy people, the arteries are relaxed but inflammation is possible. This may happen due to unhealthy lifestyle of fast foods and sedentary lifestyle. Increased fat intake causes cholesterol that should normally flow along with blood, to be retained in the vessel wall and this leads to heart attacks and strokes.
WHAT DOES THE VASCULAR PROFILE TEST TELL YOU?
Handy clinical information can be gathered by the use of this test. It works on the principle of ABI (Ankle Brachial index) and PWV (Pulse Wave Velocity) as an index of arterial wall stiffness and peripheral arterial disease (PAD). Therefore the test is useful for
- Early detection of hardening and stiffening of arteries
- Determining the biological age.
- Assessing complete cardiovascular health including:
- The state of the heart by an electrocardiogram (ECG)
- The sounds of the heart by a phonocardiogram (PCG)
- The state of blood vessels by checking blood pressure
- The blood flow in the blood vessels and progress of inflammation by recording the pulsation wave of your artery.
Make suitable lifestyle changes:
- Reduce the intake of oily food, butter, fast foods
- Exercise regularly
- Refrain from smoking
- Relax-do not get stressed
- Get your lipids in order by a routine check
- Follow your doctor's advice on medications, diet and exercise
ADVANTAGES
Real-time characteristics of blood flow and vascular patterns through the arteries and veins are the hallmark of cardiovascular monitoring. But to derive such cardiovascular information one needs to use highly invasive methodologies rendering the patient to various risks and morbidities. Infections with blood borne diseases such as AIDS and hepatitis are a major problem both to the patient as well as the personnel involved. Complications can cause unnecessary and extended hospital stays. Also invasive techniques require sophisticated infrastructure and highly skilled professionals on the job. Herein lies the inherent advantage of the non-invasive vascular profiler, which measures elasticity of the arteries on the basis of parameters like height, weight, BMI and blood pressure. Such a procedure finds immense application in the situations where continuous cardiovascular monitoring is required especially among the elderly and the test is bound to have a positive impact on the quality of health care.
Article By Dr.R.Ravindranath M.D., Consultant in Cardiac & Diabetic Care, Chennai
For further details contact 9381047102 , ravidiacare@yahoo.com
