Rain

Though late, the South-West monsoon [the main source of Rain for this area] finally have been kind enough to my native state, Kerala.

Until this week, Newspapers were saying that this was the weakest monsoon in recent memory with a 43 percent deficit in rainfall in the first 7 weeks of the season. Power blackouts started [as the major source of Power here is Hydro-electric projects] and fear of failed crops were looming large.
This week everything changed. The sky started pouring and pouring. Even as I type, I can hear the wonderful sound of rain. Newspapers started talking about flash floods and landslips. Let us hope the monsoon will wipe off the rainfall deficit in quick time.

Rain or no Rain,Chikungunya epidemic continues relentlessly. In some families, almost all members are getting affected. I had an opportunity to visit a small town 15 kms away. I went there on invitation of a local Club. They wanted me to give a health education class about chikungunya fever.
When I reached there, the people were not in a mood to listen to a talk. They wanted prescription for medicines so that they can recover fast. Most of them were manual labourers, and the persistent joint pain and swellings were preventing them from working. Some wanted preventive medicines to protect them from the virus. I was helpless. There is no fast cure.The joint pains may last for weeks to months. During that period, they will have to continue taking anti-inflammatory drugs. Also, there is no preventive medicine or vaccine yet. I asked them to take measures to reduce breeding of Aedes mosquito. I also asked them to isolate the patient inside a mosquito net during the time of fever. At that time, maximum number of viruses are there in patient's blood and mosquito bite can easily spread the illness.
My team saw more than 50 patients. Some free medicines were distributed, but nobody was satisfied. As we drove back, my thoughts were on the enormity of physical and economic damage this virus had brought on the society, especially for the poor.

Craze for Specialist Consultation

Recently, I had an interesting experience. A-25-year old guy working in a Software Company in Banglore came to me with complaints of lack of appetite, giddiness, nausea and headache of a week duration. He had seen a doctor there in Banglore but the medicines prescribed did not help him.
Just looking at his eyes made me realise he was jaundiced. I examined him fully and came to a conclusion that he was having jaundice probably due to acute viral hepatitis. Before ordering a panel of tests to find out the exact cause of jaundice, I asked him to show me the Banglore doctor's prescription. He gave it to me little reluctantly. To my utter surprise, the doctor he had seen is a senior consultant in Neurosurgery at a posh hospital. The doctor had not spotted jaundice, may be because at that time [6 days ago] it was not as evident as it is now. He had given him anti vertigo and anti vomiting tablets.
I was curious.Why you went to a neurosurgeon? He said his friends told him it was better to see a top most consultant of Neuroscience as they all felt the problem was in Brain. Still why a surgeon? You could have gone to the neuro-physician? The reply shocked me.Only the neurosurgeon in that hospital had an American degree.
This craze for specialist consultation [after self diagnosis] is growing among the upper and middle income groups in India. Most often this leads to delayed diagnosis and delayed treatment. Many doctors also encourage this for selfish motives. The patient with headache go to a neurologist first and the one with chest pain will always go to the cardiologist first. The concerned specialist first rules out all the illnesses that he can treat by a panel of investigations. If all are negative, then only the patient is referred elsewhere.

With tons of medical information available on the Internet, many patients believe that they can diagnose themselves. They also believe that they can chose the specialist they want to consult. Many decides which medicines they will take and which they would not. Is this trend of patient emancipation beneficial to the society? Many believe so but I am not so sure.


.

Alternative Medicine

Can I use this Ayurveda Medicine along with what you had prescribed for me for Diabetes?
Can I use this 'Insulin leaf' for controlling my blood sugar?
Can I use this homeopathy medicine to prevent getting Chikungunya fever?
I hear such questions again and again.The popularity of Alternative Medicine is ever increasing.As long as there are illnesses there will be Alternative Medicine.
Recently I read an interesting article in The Guardian' titled 'A bad week for alternative medicine' by Rose Shapiro.I agree with most of her points. For those who do not have time to read the article in full here are some excerpts that I liked.

Alternative medicine users are apparently prepared to suspend all normal critical faculties when they encounter an alternative practitioner

Quacks often use language that is abstract and subjective but is ultimately meaningless. Words such as "quantum" sound impressive to those of us with only a weak grasp of theoretical physics, but are in fact nothing but pseudo-scientific window dressing designed to lure a gullible public.
Quacks will often tell you that feeling worse is a sign of getting better. Most detox regimes describe symptoms such as spots, bad breath, headaches and nausea as proof that the detox is working. Such a notion is central in homeopathy, which enables practitioners to rationalise away the worsening of their patients' symptoms

The orthodox doctor treats what you have, and the alternative practitioner says you have what she treats

Quacks are flattering and will appeal to your vanity. They tell you that you are unique and extraordinary and not like other people. On the rare occasions that they find nothing wrong they say you need maintenance treatment "in order to keep your energies in balance

Many alternative practitioners sincerely believe in what they are doing and want to help their clients. But there have surely been enough cases now of blatant recklessness if not outright deceit to confirm that practising alternative medicine is very often the last refuge of the scoundrel.

I live in an area of India were ancient Indian Medicine [Ayurveda]have strong roots. Even the name Charakan, I chose in respect of a great ancient Indian Physician called Charaka who lived about 2000 years ago. At that time Ayurveda was one of the most scientific of all medical systems, but it stagnated and went into decay as Scientific medicine within a few hundreds of years. Still, the Ayurveda practitioner used to uphold ethics of high standard. Now in the 21st century, Ayurveda is also fast deteriorating into a money-making business exploiting gullible public like all other Alternative Medical systems.
How do I answer the the above questions of my patients regarding Alternative Medicine?
I just answer 'I don't know'.
Then I explain saying, 'I have not studied Alternative Medicines. And as far as I know they don't have any scientific basis. So if you want to experiment on yourself you may take them.Otherwise don't take them.'
Then they will ask 'as there are no''side effects''what is the harm?'
My reply will be 'I have seen many patients who suffered from severe side effects due to Alternative Medicines.Also such medicines may interact with the medicines I have prescribed.'

Hearing all this most of my patients wont dare to take Alternative Medicine.