Articles on chronic condition

Chronic Kidney Disease - Silent Killer

Dr. Ajay Goyal, Nephrologist
Chronic kidney disease (CKD) is a condition in which kidneys are damaged and their ability to keep a person healthy is decreased. The main role of the kidneys is to filter waste products from the blood before converting them into urine. The kidneys also:Help maintain blood pressureMaintain the correct levels of chemicals in your body which, in turn, will help heart and muscles function properlyProduce the active form of vitamin D that keeps bones healthyProduce a substance called erythropoietin, which stimulates production of red blood cellsCKD is the reduced ability of the kidney to carry out these functions in the long-term. This is most often caused by damage to the kidneys from other conditions, most commonly diabetes and high blood pressure. If kidney disease gets worse, wastes can build to high levels in your blood and make you feel sick. You may develop complications like high blood pressure, anemia, weak bones, poor nutritional health and nerve damage. People with CKD are known to have an increased risk of a heart attack because of changes that occur to the circulation. These problems may happen slowly over a long period of time. Early detection and treatment can often keep chronic kidney disease from getting worse.Talk to your doctor about your kidneys if you:Have diabetesHave high blood pressureAre obeseSmokeAre over 50years of ageHave a family history of kidney disease, diabetes or high blood pressureHave swelling over feetThree simple tests to check for kidney disease are Blood Pressure, Urine analysis and serum creatinine. Early kidney disease can and should be treated to keep it from getting worse.

Some Devastating Statistics About Chronic Kidney Failure in India

Dr. Prashant C Dheerendra, Nephrologist
Even as we speak chronic kidney failure is taking a huge  toll on  lakhs of families in India. This is unfortunate because kidney failure is the easiest of all organ failures  to manage.  We have dialysis which can replace kidney function to a significant extent and kidney  is the easiest solid organ  to  transplant. This sad situation is because of a number of factors, the most important of which is the lack of awareness at all levels of the society. Compared to similar patients in the developed world or even some other developing countries, kidney failure patients have extremely poor outcomes in India. As things today we are not even addressing the tip of the iceberg. Given below are a few devastating statistics about chronic kidney failure in India.17% of Indians have some form of chronic kidney disease. This figure was reached that in a study conducted by Harvard Medical School in partnership with 13 medical centres  all over India. One third of the above people have advanced stages of the disease. There are  60 million people with diabetes in India, more than any other nation on the planet. Sadly, the majority of them are either  not diagnosed or poorly treated.At least 30% of diabetics will develop chronic kidney disease because of diabetes. People with the last stage of kidney failure (technically called Chronic Kidney Disease Stage 5 or CKD-5) require dialysis and/or kidney transplantation as a life sustaining treatment. 40 % of such patients would have developed kidney failure because of diabetes.2,00,000 new patients need dialysis treatment every year in India.  but the unfortunate reality is that only 10 to 20% of them get proper treatment.  The remaining are either not diagnosed or unable to continue proper treatment.Statistics suggest that there should be almost 20,00,000 people on dialysis in India a sof today. The reality is that there are only about 1,00,000. The rest have been lost due to non-diagnosis and non-treatment.The majority of chronic kidney failure patients are diagnosed in the last stage. Though proper statistics are not available, it is accepted that almost 50%  first see a nephrologist (kidney specialist) only in the last stage.There are 0.4 dialysis centers per million population in India. By contrast, Japan has 20 dialysis  centres  per million  population.Only 4,000 kidney transplants are  performed every year in India. The United States  with one fourth the population of India performs 16,000 such operations per year.Kidney failure can affect people of any age group. While in the west, the majority of patients are elderly, in India kidney failure patients are much younger and affects predominantly the working population.

Effective Management of Chronic Renal Diseases Through Ayurveda

Dr. Krishna Bhat, Ayurveda
Renal disorders are increasing nowadays, may be reasons are many including self medication, food habits, exposure to certain chemicals, lifestyle etc. As kidney is a very important organ to maintain equilibrium of body by eliminating the waste from our body or filtering blood - its health is must.In case of chronic Kidney disorders, current science doesn't have effective medication, especially to cure the condition. So here by I am giving an insight to Manage such problems with natural way of healing -  "AYURVEDA ".Based on my experience in treating kidney disorders I am suggesting the world to go for Ayurveda in case of such conditions.                                       Few reasons why AYURVEDA is more beneficial in such conditions are:In Ayurveda we use natural medicines ( Organic compounds) which can be easily absorbed and also eliminated without extra efforts.Natural medicines can stimulate Nephrons and help for regaining its function.Researches  prove that natural medicines used in AYURVEDA can improve structural and functional integrity of kidney better than any other medication.In case of kidney disorders any medication containing synthetic chemicals cause further problem as it is the organ filtering those chemicals to eliminate them.As kidney has many functions other than filtration like assistance in blood synthesis, maintaining blood pressure etc, multiple systems are involved in kidney disorders. As Ayurveda treats body as a whole, instead of giving many medicines we can use single medicine acting in multiple systems involved in pathogenesis of  disease.The medicines used are very much safe, instead of side effects we will get side benefits. As we give disease modifying medications for root cause and not symptomatic managements like other systems whatever improvements we get will be long lasting.As all the medicines are natural ones we can use in any age, any severity with certain modifications.In my next articles I will give some practical experience with case presentations so that it will be more convincing than any theoretical explanations. 

Is Chronic Fatigue Syndrome Making You a Zombie?

Dr. Vishwas Virmani, Physiotherapist
While Chronic Fatigue Syndrome has no known cure, the right kind of diet can work wonders in keeping your energy levels up. CFS is no easy condition to live with. However, with a few simple lifestyle and diet changes suggested here, there's no reason why someone with CFS can't be in control of the disease, rather than letting it control everything they do in their life.With our list of food dos and don'ts, keeping the symptoms of CFS in check will soon be a cinch.Curb the carbsTry and follow a low carb diet as much as possible. Cut out foods that contain processed and or refined carbs such as white bread, crackers, cookies, cakes, and soft drinks. Replace these with fresh fruits and vegetables to immediately feel more energetic. Avoid sugar and artificial sweeteners as they initially cause a rapid rise in blood sugar, followed by a sharp dip. This roller coaster causes fatigue and anxiety, leading to further sugar cravings. Soon, you'll be on this vicious cycle that leaves you totally drained.The heart of the matterSteer clear of foods that are are deep-fried, have high saturated fat content or excessive salt. These put you in the high-risk zone of developing cardiovascular diseases. However, do include healthy fats such as extra virgin olive oil in your diet to boost your immune function, correct hormonal imbalances, and also help with cognitive function. What's more, they're also an excellent source of energy!Protein powerGive dairy products such as milk and cheese a miss and switch to animal protein found in white meat, fish, and eggs. These are excellent sources of several essential amino acids that your body needs to function smoothly. Snacking on nuts and seeds in between meals is also a good way to get your protein fix.

Simple Breathing Exercises for Chronic Obstructive Pulmonary Diseases

Dr. Radhika Bharath, Physiotherapist
What is COPD?Chronic Obstructive Pulmonary Disease (COPD) is characterized by breathlessness (short of breath) or getting tired while breathing. COPD is an umbrella term for conditions such as chronic bronchitis, emphysema or a combination of both.Exercises of COPD• Deep breathing exercise:1) Diaphragmatic Breathing:- Sit Upright with back support- Look straight with chin neutral.- Place both your hands (palms one over the other) on your stomach (mid- abdomen)- Now take a deep breath in through your nose and feel your stomach move out (like an air filled balloon)- Make sure your chest does not move while breathing.- Once you have breathed in maximum, slowly breath out only through your mouth (as you blow a whistle) and feel your abdomen going inside.- Repeat this 10 time x 3 times a day2) Collateral Breathing: - Sit upright with back support - Look straight- Place your hands on the side of your chest wall (one hand on either sides)- Now take a deep breath in through your nose and feel the walls of your chest (rib cage) moving outwards as your chest expands.- No upper chest movement to be performed.- Now blow out the air through your mouth (as you blow a whistle) and feel the chest wall coming inside.- Repeat it 10 times x 3 times a day3) Apical Breathing:- Sit upright with a back support- Look straight, chin up- Place your palm across your upper chest (as the tips of your finger touch the collar bone).- Breath in through nose and feel the upper chest moving up.- Now once you have completely breathed in, slowly blow out through your mouth (as you blow a whistle) and feel your chest coming down to normal.- Repeat it 10 times x 3 times a day• Chest Expansion Techniques:1) Sit straight on a chair with back support (can also be done in lying).- Keep both the arms stretched out in front of the chest.- Now take your arms to the side and breath in through nose.- Slowly bring back the arms back in front of the chest and breath out through mouth.- Repeat 10 times 3 times a day.2) Sit on a chair with back support.- Keep both the arms stretched over head.- Bring both the arms to your shoulder level and breath in through nose.- Now gently take the hand back over head and breath out through mouth.- Repeat 10 times x 3 times a day.STAY HEATH WITH REGULAR EXERCISE!! GOOD LUCK!!

Smoking and Coping With Copd

Dr. Vandana D.Prabhu, Pulmonologist
Mr. X was a smoker and knew it was bad for his lungs. But he was more scared about having a heart attack. So he took an ECG every year but it was always normal, and his chest x-rays were clear. Even though he was getting breathless and coughing a lot, he thought it was a normal smoker’s cough. He ignored it till he reached a stage where he couldn’t walk far without breathing difficulty.Now he has given up smoking, and is on treatment for COPD. It was tough to quit smoking, but with will power he succeeded. He now feels much happier and goes for his morning walk comfortably.COPD is the short form for Chronic Obstructive Pulmonary Disease. “Chronic” means that it will not go away. “Obstructive” means partly blocked. “Pulmonary” means in the lungs. This means that you need long-term treatment for a disease that is causing some blockage in your lungs. The air tubes which carry air in and out of the lungs become narrower, so the amount of air that goes in is much less. Also, air cannot get out of the lungs properly. Because of this, the patient feels breathless, his lungs feel very full, and his chest feels tight. These are the symptoms of COPD.Smoking is the most commoncause of COPD. People who get COPD are usually smokers over 40 years of age. Theymay be ex-smokers who have quit, but already have lung damage. Even non-smokerscan get COPD if they keep breathing in second-hand smoke. Constant exposure tofumes from burning firewood or charcoal is a risk factor. That is how women inrural India get COPD from their cooking stoves {“chula”} or room heaters[“sigri”]. Asthmatics can get COPD if their asthma is not properly controlled.Occupational exposure to dusty or smoky air like coal mines; or otherindustries like cement, textiles and chemicals may also cause COPD.The patient is asked to doa breathing test called spirometry; by which the doctor grades COPD as mild, moderateor severe; and decides on the treatment plan accordingly. Newer inhaledmedications are safe and effective for long-term treatment. The most importantadvice is to stop smoking and take the prescribed medicines regularly.The patient’s condition canget worse even if he smokes just two cigarettes a day. Cigarette smoke reducesthe lungs’ immunity against infections. It irritates the airways which getnarrower and produce excess mucus that blocks them. If the patient’s willpowerto quit smoking is not enough, the doctor may recommend a nicotine patch/chewing gum. This nicotine substitute reduces withdrawal symptoms like anxiety,restlessness and craving for tobacco smoke.To QUIT Smoking:Set a definite date when you will stop smokingcompletely.Tell your friends and family that you are tryingto stop. They will support and motivate you.Take one day at a time. Mark off each successfulday on a calendar.Avoid people who smoke and places that make youwant to smoke.Remove all ashtrays, cigarette packs andlighters from your home.Keep your hands busy. Whenever you feel likepicking up a cigarette, pick up a pencil instead.If you feel an urge to smoke, chew some nicotinegum instead.If you start smoking again, don’t give up onyour goal. On an average, people make 3-4 attempts to quit before they stopsmoking permanently.Keep the air clean in your home. Avoid smoke,fumes, and strong smells. If your house is being painted or pest-controlled,stay away.If you are cooking, keep the kitchen windowsopen and use an exhaust fan.On days when there is lot of pollution and dustoutside, stay at home and keep the windows closed.If you are overweight, it is harder to breathe.Try to lose weight.If you become breathless while eating, eatslowly and talk less.Eat fresh fruits and vegetables; in smallamounts but more frequently.Drink lots of water. This helps make the mucusin your lungs thinner, so that you can cough it out easily.Do breathing exercises. Walk slowly for 20 mindaily. If you feel breathless, stop and rest.If your COPD is very bad and you have beenhospitalised, the doctor may advise you to take oxygen at home. You will have toarrange for an oxygen cylinder or an oxygen concentrator.If breathing becomes very difficult, and it ishard to walk and talk, it may be an emergency. Go to the hospital right away.


Dr Aaina
A rheumatologist is an internist or pediatrician, who received further training in the diagnosis (detection) and treatment of musculoskeletal disease and systemic autoimmune conditions commonly referred to as rheumatic diseases. These diseases can affect the joints, muscles and bones causing pain, swelling, stiffness and deformity.Autoimmune conditions occur when the immune system sends inflammation to areas of the body when it is not needed causing damage/symptoms. These diseases can also affect the eyes, skin, nervous system and internal organs. Rheumatologists treat joint disease similar to orthopedists but do not perform surgeries. Common diseases treated by rheumatologists include osteoarthritis, gout, rheumatoid arthritis, chronic back pain, tendinitis, and lupus.Many rheumatologists also conduct research to find a cause of and better treatment of a rheumatic disease.How is a rheumatologist trained?A rheumatologist must complete four years of medical or osteopathic education followed by three years of residency training in either internal medicine or pediatrics. Some rheumatologists are trained in both. After residency, they must enroll in a rheumatology fellowship for two to three years to learn about chronic musculoskeletal and autoimmune conditions and their treatment.Rheumatologists then take a board examination to become board certified in rheumatology. This certification/exam has to be retaken every 10 years. Physicians are also required to participate in a certain amount of continuing medical education on a yearly basis.

Father Day: What Should I Gift Him?

Dr. Sandeep Nayak, Surgical Oncologist
Health and Happiness!The key to a healthy life is early detection of any disease.  The idea is to identify the disease before it causes irreversible damage. This applies to all chronic diseases like hypertension (high BP), diabetes or cancer. Among these the first two cannot be cured. However, cancer is curable if it is detected early. Let us discuss a few tips for healthy living that would benefit your dad. The key to healthy life includes healthy habits like exercise, meditation and addiction free life. These three contribute to most of the chronic ailments. Tobacco contributes to more cancers than any other single risk factor. Healthy food habit is also very important in preventing diseases. Low calorie diet with plenty of fruits and vegetables is far healthier than fatty food items. So, help your dad to inculcate these healthy habits. There are some cancers that you should be aware of when it comes to your father and it is important that you get the screening tests done before symptoms start. These tests include a blood test for prostate cancer (PSA), a stool test for colon cancer and an ultrasound scan to look for internal organs. These are advised once in a year, once your dad is above 50 years of age. Also other tests for detecting heart ailments and diabetes are done at the same time. Remember that cancer is a painless disease until it becomes advanced. Do not allow him to wait on a painless symptom. Here I am sharing my video on Early Detection of Cancer and Cancer Prevention. This would be the best gift you can give you dad. Happy father’s day!