Randomness

Moonlight
.
Open roof diner
..
Candle-lights
...
Saxophone playing in background
....
wine in hand
......
aroma of bar-be-que in the air
........
dancing through the night in your arms
..............

dream on...dreaming is still tax free..dream on girl.

I Believe..

Every spoken word...every random deed...every chance encounter...every touch leaves an imprint on the sands of time...by leaving behind a memory in the hearts and minds of the one's we touch while walking through the journey of life.

             And even when this life fades away and we cease to exist...a part of that life..how soever tiny continues to live on..as the memory of our deeds, our action...at times passed on as a word of kindness, at times remembered with fondness & gratitude, at times quoted as an example of a good deed...& thus through the fabric of time...We live on through our deeds.



 It doesn't mater how long a life we life, what matters is how we live the life, that we lived, even if for a few moments.


These words of Ben Jonson, are the gist of what i wrote above,


 A lily of a day,

Is fairer far in May,
Although it droop and die that night,
It was the plant and flow'r of light.
In small proportions we just beauties see;
And in short measures, life may perfect be.

Randomness

 For no reason, that I can think of, I just recalled the last day of my MBBS curriculum today..the last of all the many countless exams that we had given over the duration of 4 yrs during our medical journey. It may be hard for you to understand the post if you are not a medico..so I'll describe in brief, what our academic year is like..before moving on to why I began writing this post.

I had hardly started with the academic year when I found myself staring face to face with an exam at the other end of the fortnight. I forgot the count of exams by the time I was 6 months into the 4 yr long course...All that I can recall is a blur of the nervousness, the tension, the madness, the fear of the unknown, the fear of Murphy's law of medicine..the topic u forget to read out of the 15 odd books will be the one the Examiner will remember to ask, the sleepless nights before every exam and the reminder of the next one all ready to grasp u...in between these exams was packed up our whole life, the moments of fun, longings, bonding between colleagues riding the same boat, gossips, lack of sleep, disappointments, successes & never ending fatigue..

                    And then, there comes the day, about which I mentioned at the beginning of the post..the day of the last exam and when the last exam ended..I returned back..got through the routine of the post examination discussion..got back to my room..fell into senseless sleep from all the accumulated fatigue.

                              And then when I woke up...with mind all alert and geared up to begin the preparation for the next exam...I came face to face with the void...the blank...of no more exam...In that moment, I realized that it's all over (atleast for a year or so till the Post Grad entrance exams begin)..For sometime I laughed at the MBBS monster..that finally I made it alive out of it's clutches, in one piece, in one go...and then the world came crumbling down with the emptiness settling in..I did not know what to do in those few moments, I could not understand what all those 4 years had been about...having surrounded myself with the pseudo heaven of studies, work, college & exams..I forget for a few moments all the plans lying written on a piece of paper, during those hours when I had madly wanted all this to end...I remember crying, trying to understand the emptiness that I was feeling..It was definitely not what I dreamed I would feel when I made it to the biggest day of my life.

                                  Today, I realize that that emptiness was not a void of helplessness...but the emptiness of having found what I had started out for...a state of bliss..a state which can only be achieved, after having, loved, lived and having worked hard for a dream, I had dreamed...Those were the moment of bliss I had earned...bliss that I now know I shall never find again in life, after having entered and seen the grind of professional medicine...that pure feeling of becoming a doctor, the dedication to serve, to heal, the pure exaltation of a child who had dreamt of reaching out to the sky and pulling down the stars and in those few moments..something within the child knew that she had caught her star...something that had given her a few moments of peace, hoping that those moments would help her last through a lifetime of hell....

                                                      Wish I could find that certainity again.

Randomness

Quiet Saturday Morning
..
...
Bob Marley
...
....
Cup of Hot and Steaming Coffee
....
.....
Favorite Pair of Old Faded Denim and T's
.....
.......
Canvas, Paints and brushes
.......
........
Paper, Ink and Fountain Pen
.........
...........
DSLR and Pics
..............
..................
The day this comes true..I'll know I accidentally lost my way and found heaven.

I Believe..

Whenever looking around the world & all that's happening in it..I feel like loosing faith in humanity..I remember the look I had seen in the eyes of this 6 month old baby, when I was cannulating him..from the depth of those I could see staring back at me an unconditional surrender..the surrender of trust & faith in another human being, in the humanity that the soul of that child could perceive...That look has always stayed with me & in the moments of darkness..has given me hope to rise up & walk towards th light..'cuz  I could never let down the faith of that little child

I Believe..

Even in the darkest of the human soul lies in a tiny little corner, a part untouched by darkness...filled with the purity with which it was born.

I Believe..

Poetry is a soul laid naked....The sensuality of the raw flesh is what makes it so beautiful.

Contraception - 2

In the last post I'd talked about the Barrier methods of contraception. This post is dedicated to Hormonal methods of contraception.

As I had explained in the last post, contraception is achieved by preventing the sperm & the egg from meeting or if the meeting has taken place, then from preventing the mated egg & sperm to settle down in body & grow up into a baby.

For the entire reproductive process in human body, both males & females, certain hormones are essential. In women these hormones rise & fall with different phases of monthly cycle. The timely & adequate rise & fall is essential for the normal functioning of cycle. Imbalance between these hormones leads to menstrual irregularities or scanty or heavy cycles & Infertility. So it is essential that these hormones remain in balance.

The Two most important hormones of female reproductive cycle are Estrogen & Progesterone.The interaction between these to decides the time when egg is released & if fusion between egg & sperm takes place, they condition the Uterus to receive the fused gamete & help it grow.

All the Hormonal pills bring an imbalance between these two hormones & thus preventing fusion of the egg & sperms or else preventing the fused product to settle. But these drugs if taken without supervision & in inadequate or too high doses can lead to hormonal imbalances & menstrual irregularities. Thus these pills should be used with CARE, CAUTION & UNDER MEDICAL SUPERVISION ONLY.

I have seen cases where women who use Contraceptive pills to abort, ended up bleeding profusely, some even die before we can help them medically. At times improper consumption of pills leads to severe menstural irregularities, changes in hormonal cycles.

Contraceptive pills though have very high efficacy in preventing pregnancy, there disadvantage lies in the fact that they DO NOT offer any protection from sexually transmitted diseases. So while using OCP's you should make sure that your partner is using a Condom.

Currently Hormonal pills are used as-

Oral Contraceptive Pills - to be used daily, as directed by the doctor till the woman does not want to conceive. (Long term consumption of OCP has been associated with risk of breast cancer, so do make sure that you raise this concern with your doctor)

Emergency Contraceptive pills - Used as an emergency measure to prevent pregnancy within 72 hrs of having Unsafe Sex. These days due to heavy advertising, I-pills have become a convenient alternative for women to use after unsafe sex.This highly irresponsible & dangerous. In such circumstances, these pills be consumed only with consultation of a doctor.

Medical termination of Pregnancy in early weeks of pregnancy - We get a lot of patients in the OPD who come to us after having consumed drugs to abort & then ending up in emergencies or women who insist that we give them drugs to abort pregnancy irrespective of the age of gestation. A word of caution about this. Use of Drugs to abort should be done only with MEDICAL ADVICE, this is for the good of your own health & life.

As I have said before, don't get swayed by the massive Information that is available these days, Use that information Judiciously. Act Responsibly & Stay Safe.



(This post contains just basic medical information regarding Hormonal pills for general awareness. It is not intended as medical advice nor should it be taken so.
Kindly turn to your doctor in case of any queries regarding the above post.)

Haunted

Haunted,
I run
seeking an escape.

Haunted,
I turn around,
to stare into faces that are my own.

Haunted,
I wish to break free
and find an escape.

Haunted,
I break against,
the Iron bars of my cage.

Haunted,
I cry,
I bleed....

Beaten,
again by chains of love,
I give up in the end,
to lie again,
in the pool of my tears.
.
.
..
.
Haunted..
I shall rise again,
to seek my escape.

I Believe..

  

  

It's so easy to pretend & be good at something & get loved for that pretense...&  yet, it's so diffcult to be who u really are & be loved for that.

That is why,


 I walk,

in the shadow of the mask,

Never letting it fall,

'cuz behind the shadows,

beneath the gaiety,

lies a dark sorrow,

unspoken

unwept

unheard..

lying dormant, 

waiting to explode.

August 15th

                     A nation represents the collective soul of the Individuals who are it's Citizens & the State in which a nation is..is a reflection of the attitude that it's people have towards themselves & each other.

Why am I writing this post today?

Because...

It's August the 15th again---- The significance of the day---- It's The Indian Independence Day. What am I going to do for this occasion... I'll probably go to my hospital do the duty  while feeling a little pissed that It's Sunday this 15th Aug & I have been robbed of one of my 11 precious gazetted holiday (to be honest with the kind of work schedule I have the right to crib on loosing my holiday).

And No, I won't go ahead & buy the national flag (which kids go about selling on every traffic signal around this time in India) & wave it around or tweet facts about the greatness of India the nation or add a Patriotic status to my long line of FB status messages or listen to patriotic songs or sit back and discuss how everything starting from public administration to living conditions to law & order is on the down hill & curse the government & politicians for the rotten condition of Nation.

Why?? Here's the reason ---

I don't think how does it help..if we wear patriotism on our sleeves on one day, while shirking away from our responsibilities & duties as a citizen day in & day out. Where is the patriotism when we forget basic civic manners like forming queues, not spitting or peeing in public, respecting women & elderly people, obeying traffic laws, keeping our environment clean, judicious use of energy?

What good can come out of waving a plastic tricolor..which has been made & is being sold by children (who are the future of this nation) in factories when they should have been in schools, happily fed in families.

Should I feel proud to know
that I live in a country where still families throw away newborn girl child or worse kill a still unborn child 'cuz they want sons or wives are burnt for dowry or subjected to domestic violence ?

Where people are killed for marrying against the wishes of their family & these killings are termed Honor killings.

Where people discriminate against fellow human beings on caste, religion, region, discriminate enough to kill.

Where citizens are Indians on 15th Aug/ 26th Jan/ 2nd Oct & for the rest of the year they beat each other up for being North Indians, South Indians, Maharashtrians, Kashmiris, Maoists, Communists the list is unending.

Where citizens spend  more time finding innovative ways of by passing laws, evading taxes & using that money for bribes.

Where cricketers, actors & pseudo celebrities roll in luxury & soldiers, teachers, scientists & farmers are left unthanked for.

Where news is about earning TRP's rather than reporting facts.

Where elected representatives of the country fight tooth & nails with each other in the Parliament, spend more time staging walk outs & getting the house adjourned than discussing the problems of nation, spend crores in making statues & parks while millions die of mal-nourishment & hunger, where nothing lies above petty politics & earning the vote bank.

Where We The People elect Such leaders to rule us, what right do we have to crib?

The purpose of this post is not to criticize a nation that is the biggest democracy in the world over flowing with talent unlimited.. I fully realize that some of the things that I have mentioned above are rampant in every society..but then ours is the nation which stands on the premise of Vasudhaiva Kutumbakam (The whole world is a single family)

               The purpose of this post is merely to show ourselves the mirror..to remind ourselves that --

The change will not happen by sitting in our homes, worrying about our comforts, refusing to accept reality as it is & waiting for someone else to come & clean our own backyard..To make the change happen we will have to shirk off our laziness, clean our minds & then pick up our brooms& clean up our backyards.

Let us be responsible people everyday of our life & celebrate patriotism everyday rather than make a hue & cry of it for a couple of days a year.

                                   Remember, The wall lies within your own mind.

Nemesis

I cannot turn around,
I cannot run away,
I cannot hide..

For me,
there lies no escape,

haunting me,
is a nemesis,
that is my own...
Not a shadow unknown.

The beseeching cry of my own soul,
mirroring,
the sighs of my bleeding innocence
lying stabbed,
with daggers wrought,
in the fire of the sins that were my own.

I Believe..

that the idea of an idea leading to the birth of another is the essence of true creativity.

Contraception - 1

This will not be a single post but a series of post about Measures of contraception & the sensible use of various Contraceptive measures available.

Contraception is simply referred to as any method by which a woman doesn't get pregnant while still being sexually active.

Methods of contraception are divided into

                                  - Reversible (woman can conceive soon after they stop using the method) 

                                  - Irreversible/Permanent (inability to conceive once the method has been used)

Reversible Methods can be of Various Types like Barrier methods (e.g. condoms), Hormonal (Oral Contraceptive Pills), Mechanical (Intrauterine devices like Cu-T).

Today's post will be focused on Barrier Methods.

Barrier Methods - As the name suggests, act as a barrier in preventing the egg & the sperm to meet thereby preventing Pregnancy from taking place.

The commonest Barrier protection method in use these days is the Male Condom (& yes female condoms do come, but they are very expensive, cumbersome to use & at times uncomfortable). 

Male condoms are the easily available, cheap,easy to use, safe & disposable contraceptive devices.

The added advantage of Condoms is that they prevent transmission of STD's & HIV infection.

But a few Things need to be kept in mind while using a condom. For that it's essential to understand that Condom is like a glove that covers the penis & the ejaculate containing sperm is collected in this glove thereby preventing it from spilling into vagina. For the Condom to function efficiently it is therefore essential that the condom is of right size, good quality and covers the penis completely, has space to collect the ejaculate & is intact to prevent the ejaculate from spilling accidentally & beating the purpose of the device.

Check-list before using a Condom -
- Press the tip of the Condom to remove air if any in the condom

- Before using just pour a gentle stream of normal water in it to check there is no leak.

- While removing after coitus make sure that there is no spilling of the ejaculate in vagina & also check the condom for any tear that might have happened during the act.

- In case of tear / leak in condom please make sure to I for your partner and get them to Consult a Obgy specialist.

- It increases the efficacy of condom if the female uses a spermicidal jelly, but this should be done in consultation with your OBGY specialist.

Using condom has no effect on the sensation of the sexually act as is commonly believed.

Also the latest condoms are free of the allergic reactions that sometimes used to occur with latex condoms.

But more important than knowing all this is Acting "Responsibly". It is very Important for sexually active Men & Women (of any age group) to "SAY NO TO UNSAFE/ UNPROTECTED SEX".

U should insist that your partner use a Condom while having sex, because AIDS/ STD's do not have any sexually preferences. They affect both the sexes & AIDS kills both men & women equally. If the partner has any reservations get him to talk to a doctor but donot give in to "Unprotected Sex" in any case.

Also, getting accidentally pregnant due to unprotected Sex, not only leads to emotional problems, apart from the toll repeated pregnancies & abortions to get rid of unwanted pregnancies take on the body of women.

I have seen countless patients go through the mental & physical trauma of the effects of such irresponsible acts, at times even leading to deaths.

I once had a patient, a young girl who got infected with HIV because she had had unprotected sex only once with her boyfriend because he refused to use Condom even when she Insisted, both being unaware that her Boyfriend was HIV +ve. There are many such stories that we as doctors come across daily, Incidents which ruin families & individuals.

ALWAYS REMEMBER THAT U CAN SAY NO and THAT ONE NO CAN SAVE YOUR ENTIRE LIFE. So donot hesitate to make that choice. LEARN TO SAY NO.

I'll wrap up this post with this bit of Caution. We live in the age of Information, the motto of which is "if it's a question, it can be googled". But what can't be googled IS how to use that information correctly, this especially applies to Medical Information. The Information that is available online is what We doctors read all our lives in our books, but the reason why we have to slog 8-10 yrs of our lives becoming worthy consultants is so that we can decide which information is worth using for the welfare of our patients & which is not. My point is don't get swayed by the flood of information, at times too much information can kill.

I Believe..

There are some conflicts in life..that try as we might cannot be resolved..without leaving behind some scars..'cuz the answer to them lies in choosing the seemingly bad out of the worst choices that we have...but what makes the difference in the end is not the choice...but what we did with our choice... which at times even be to let go the choice & turn back up the road.

I Believe..

The thrill I get while doing a surgery is..the thrill of a fight...fight to kill a disease & help a life survive..there is no substitute for the feeling..there never will be... to be able to look into the eye of your patient (even if for a moment) & Say that you won the fight against the disease.


how so many lives I may help get better..but it will never feel the same being a doctor without being a surgeon.

Fighting Breast Cancer

I'm currently working in an Onco-Surgery clinic & since I'm dealing with cancer patients day in & out &  will be assisting Breast cancer surgeries today..I thought I'll talk a bit about the Cancer which is pretty common, carries best prognosis & survival rate if detected timely - Breast Cancer.

Breast Cancer if detected early is treatable in 95 % cases with excellent 5 yr survival rates.

All you need to do to make a mickey out of this dreaded cancer is a little timely caution. These are the following steps that can help :

- Any female above 18 yrs of age should do routine "Self-Breast Examination" every month on a fixed day 4- 5 days after Menses.

- For the examination
Stand In front of the mirror & first look at the shape & size of both the breasts.
Note any abnormality in the shape, size or symmetry of the breast, also look for any dimple or scarring in both the breast, any abnormality in the shape of the nipples or Discharge from them.

 Perform the above steps once with both your hands dangling by your sides & the with both your arms raised above your head.

After this palpate your breasts using your fingers tips trying to feel for any small nodules, hardness, pain or increase of temperature in any particular region of breast while doing so, Do Not hold the breast tissue b/w your hand & thumb ('cuz then u might confuse normal breast gland with a lump)..just go pressing your finger in a clockwise manner all over your breast.

Do this with hands down, then hands raised & finally try to feel any lump, nodule or hardness in your arm pits.

In case u find any change in size or asymmetry b/w the size of the two breasts or any nodule or hardness Please visit your Gynaecologist ASAP.

- After the age of 25 yrs it is advisable to have a Gynec examine your breast at the interval of every 3 months.

- After the age of 40 It is essential that you at least get your breasts examined by a Gynaec once (Ideally we suggest 3 monthly clinical examination & Mammogram ever 2 yrs till the age of 45 yrs & then annually, but that choice is for your Gynaec to make)

- If you have a family history of breast diseases or breast cancer or Ovarian cancer (i.e. In your mother's family or siblings) It's advisable that you consult a Gynac every 3 months for a clinical examination because of the increased risk.

- Please keep in mind that every lump in breast is not cancer. There are many other diseases that can present with a breast lump, so do not Panic, but at the same time it is essential that your disease is evaluated and treated by a doctor at the earliest.

- The Risks of Breast cancers are high in Patients who have:

•  used Oral Contraceptive Pills for long,
•  consume High fatty diet, 
• Have had Previous breast disease,
•  Have had a family history of Breast cancer, 
• Repeated exposure to radiation,
•  In smoking, alcoholic women or women who do not have kids or have not breast feed.

Such patients should be more cautious during examination.

- And for those of you guys who are lolling away at this post--- Breast cancer occurs even In men so be on your look out.

Breast cancer If diagnosed Timely, can be easily treated & Patient can lead a Normal life for long.

It's never harmful to be Cautious...So Give yourself a chance..Spread the word to as many people as you can...Help Us fight Breast Cancer.

"Prevention is better than Cure"

I am sure everyone of u readers have come across the above advice time & again. Generally we laugh this advice off, but as a Doctor I can tell u that Prevention is not just better than cure...at times it's the ONLY cure.

And when not the only cure Prevention is any day better than falling sick, feeling ill, getting a battery of tests done (in the process getting pricked & poked by countless needles) & then eating bitter medicine....So when it can be prevented, a disease should be prevented.

Since It's Monsoon season going on currently, which increases frequency of water borne, food borne & mosquito borne diseases...I'll try to line out a few basic precautions which can be of help.

Water-Borne diseases are diseases that spread due to consumption of dirt/contaminated water e.g. Typhoid, Jaundice, cholera etc.

Preventive measures :  Avoid drinking water from unsafe sources.

                                       At home boil water (best form of water purification) or use water Purifier (when    using Purifier, make sure you get it serviced as per manufacturer's guidelines).

                                       Make sure that you handle drinking water with clean hands & the water containers are covered.

                                       Consult a doctor for vaccine Preventable water borne diseases like Typhoid, Hep A (in case of epidemic)

                                        In case you notice bad smell or change in color in the your water, do notify the MCD administration of your area & your housing society. Do get your Over head storage tanks cleaned regularly.

                                         Avoid using swimming pools unless sure of their cleanliness during rainy weather.

Food Borne diseases that spread by contaminated food like gastroenteritis & diarrheal illnesses etc

Preventive measures :    Avoid eating uncooked/ poorly cooked/ stale food during rainy season.

                                     Avoid eating street food/ at mass gatherings.

Mosquito borne diseases are the disease which are transmitted through mosquitoes e.g. Malaria, Dengue, Chickengunya etc.

Preventive measures:    Wear clothes that cover your entire body/ otherwise Use mosquito repellents (trust the repellent is better than popping bitter Quinine Tablets ask anyone who's taken the tabs once)

                                     Make sure that no water accumulation takes place in your surrounding areas..Clean out the coolers/ add oil to them. Keep a look out for any bottles or jars or pots where accidental water might get accumulated (this helps to prevent mosquito breeding)

                                      In case of open drains notify the MCD & getting them to cover up the drains or else take a community cleaning drive & weekly pour an oil layer on open drains/ consult the local authorities for pesticide sprays.

                                      In case of high grade fever with chills & shivering associated with vomiting headaches, joint pains or red spots over body, CONSULT a doctor IMMEDIATELY (because certain types of malaria & Dengue can kill as fast as they can be cured If diagnosed timely).  

To sum it up, a bit of timely Caution never kills. It's your life, It's your health, So Take a little bit of time and work to Keep yourself healthy...Enjoy .

(P.S. Precautions are not a substitute for doctors and medicines...so please make sure you take appropriate medical advice while taking precautions.)