WHEN SHOULD ONE SEE THE DOCTOR?

The heading should not delude someone to think that modern medicine is poison and should be avoided. One should try and live, if possible, avoiding the ravages of modern medicine, but under certain circumstances it could be life saving, more so in an emergency situation. Modern medicine has many quick fixes that might tide over a crisis. Although our aim should be to live without medical help, using the hints given in this article, one should be aware of the situations when one has to, per force, go to a doctor and take his/her advice.



It is always better to have a good family doctor that knows the family very well. Such a doctor would be able to diagnose diseases more easily, as he would have known the environment of his patient better than a new specialist, however good the latter could be. In addition, it is safer to go first to your family doctor and he would be able to direct you to the correct specialist, if the need arose. Many a time going directly to a specialist could be detrimental both for one’s health and the purse in the fee-for-service system. Medi-business is such that at times the specialist is liable to get the patient investigated “completely” to be on the safer side to allay his own anxiety of not making any mistakes. In the bargain he could enhance the patient-anxiety, the kingpin of illnesses. This does not speak of the prohibitive cost of the present day investigations.



A good family physician, in whom you have got confidence, could allay anxiety most of the time and heal most of your common illnesses, which form the bulk of health care problems. One should be extra careful in choosing the family doctor. The Canadian Medical Association has given certain guidelines to choose a family doctor:



* He should be interested in your welfare.

* He should advice you regarding your activities and food habits.

* He should ask you about your alcohol and tobacco habits.

* He should be aware of your means for specialist care, when needed.

* He should have the “time” to “listen” to you.

* He should take care of your preventive vaccinations etc.

* During an epidemic he should help you get all the assistance.

* In short, he should be a friend, philosopher, and guide.



Choose one like that and rest content that you are in good hands. For any medical help, except in an emergency situation away from home, you should first consult him for assistance. He should send you to a specialist only when he thinks it is necessary. That way you are insuring against unnecessary investigations that might lead to unnecessary interventions.







SENSIBLE WAY OF LIVING:



One could try and live sensibly to avoid most of the avoidable diseases. That said, I must hasten to add that even if one were to live very carefully one could still get a disease. In short, disease is an accident, even though General Insurance companies in India refuse to believe that. Even with very regular check ups, using all the known modern methods of screening, there is no guarantee that one would have a healthy life. Future of any human being is impossible to predict with the present scientific knowledge. Doctors, of course, have been predicting the unpredictable, just like many other soothsayers in society! Present state of knowledge goes a step further when a recent editorial in the prestigious British Medical Journal proclaims that regular screening might seriously damage your health!



Man lives on hope. Happiness is living dangerously. If one wants everything on this planet to be one hundred per cent safe life would be miserable, if not impossible. Anxiety increases directly proportionate to the extent of safety one wishes to have regarding health. Some long term studies of people who have been very regularly checked up and treated compared to their peers who did not have that facility did show higher death rate due to heart disease and cancer in the regularly checked up group. Although this has been explained away as one of those unusual results, I have a hunch that this might be due to the enhanced anxiety associated with all those screening procedures that take away a large chunk of one’s productive life. The following Amerindian song tells it all.



I eat when I am hungry,

I drink when I am thirsty,

If heavens don’t fall down,

I shall certainly live till I die.



That is the real truth about life. Even the best of us that follow all the health freak’s rules in life could still get diseases. There are certain rules, which, if followed, could lessen the chances of illness. The rules are give correctly in Ayurveda.



Samadhaathuhu samaagnischa samdoshaha malakriyaha,

Prasanna athma indriya manaha, swastha ithyabhidheeyathe.



(When the dhaathus and doshas are balanced and when one has good appetite and proper excretory functions, one has only got to keep one’s mind, senses, and soul in peace and happiness to enjoy good health)



Happy Mind:



Anger, greed, pride, jealousy, hatred and frustration (resulting in depression) are the enemies of good health. Study after study, with very long periods of prospective observation, has unmistakably shown the above traits to be the most important risk factors for illnesses. They are more important than all the other biochemical parameters that we worry about, like sugar, blood pressure, and cholesterol or for that matter, even the latest homocysteine.

American doctors’ study, British Civil servants’ study, a Scandinavian study and of late, another American women’s study have all shown the importance of depression, occult or overt, as the deciding factor for major illnesses. Clinical depression many times is not obvious with the classical textbook symptoms. Aches and pains that are unexplainable, sleep disorders, digestive disorders, lack of enthusiasm, bowel disorders and a host of other unrelated minor symptoms could point to the possibility of occult depression. Family doctors are the best to spot these and remedy them in the beginning lest they should go on to full-blown depression with consequent major illnesses.



Modern materialistic world with the monetary economy is very conducive to have the above traits. Many of us believe that one has to have, at least, a few of those traits to be successful in life. The truth is otherwise. One could be very successful and still love others in society. It is only a question of understanding success in the true sense of the word. Our educational system, based purely on the British model, teaches some of these traits early in life in school. Although Britain has changed the competitive ethos in schools, we still continue to have it right from the kindergarten stage. Co-operative ethos in place of the usual competition would bring forth the next generation full of love for others. In an elegant study in Canada years ago the researchers had shown how the introduction of money in the aboriginal Innu land in the eighteenth century changed them from a peace loving hunter-gatherers to the Caucasian culture with all the attendant illnesses, while the aboriginal Innus before that did not have any illnesses and lived long even after a century! The title of the article is telling! “Failure of scientific medicine, the Innu community study.”



Food in moderation:



Modern clinical nutrition that we follow has no sound scientific basis. Its foundation is based on the Nazi secrets of the Second World War leaked to the allied forces. Since then we have been nibbling only at the periphery-incrementalism. Basically, food in moderation, preferably vegetarian, with reduced condiments, especially salt, (and as natural as possible) would be a sensible choice. It is best to keep our fat content less than a quarter of the total daily calorie intake.



Good helping of fruits and vegetables, as fresh as possible, would go a long way to keep one healthy. They contain plenty of antioxidants that work as scavengers to mop up the oxidants released by cell necrosis in the human body. Three helpings of fruits a day would suffice, the quantity each time need be small. Fruits that are transported from long distances would lose their nutrients fast. Local fruits that are fresh are any day better. All fruits are good.



A good breakfast, small lunch, evening snacks and a small dinner would be ideal. Keep fried foods to the minimum. Indian vegetarian diet seems to be the ideal. This should avoid preserved food and pickled food. Good helping of clean water is a must. About 30 ml. per kg. Body weight would be sufficient in warm weather. Diuretic drinks like bottled soft drinks, coffee and tea would necessitate added water intake! Having only one meal a day could be very unhealthy.



Happy environment on the dining table aids the good things in food to help keep good health for the recipient.







Exercise in moderation:



Man is made to work. Modern technological onslaught does not allow man even to lift a little finger, if he does not want to. Sedentary living is bad for health, so also is heavy competitive exercise. Moderate exercise, including gardening or housework would do. But walking for an hour a day is the best form of exercise. Jogging is not good for health. Walking on a gradient is still better. One need not walk fast to raise the pulse rate etc. Walking at one’s comfortable pace, enjoying Nature in its virginity would be ideal. The relaxation the latter affords is very good tonic for good health. One need not fuss about exercising every day. If a day or two are missed it matters little.



Sleep Well:



Six to eight hours a night of good sleep should be the ideal. The duration comes down with age. Body has its own internal clock that tells one the need for more sleep when warranted. Worrying about not sleeping enough could lead to illness.



Work ethics:



One should work well and work with detachment. Hard work never kills as long as one enjoys his work. If one hates the work even ordinary work could kill. Love your work and enjoy the fruits of your labour in the form of good health. Never try and compare yourself with others-that is mediocrity. Compete with yourself and try for excellence-that should be the motto. Ability to get on with one’s colleagues is a great asset. That needs understanding human action, and not hating, laughing at or weeping at human action.



Help others in society:



Man is made to help others. It was Swami Viekanada who said: “He only lives who lives for others, all others are more dead than alive.” That was philosophy. Now modern science has revealed the secret of good health in living for others. Modern molecular biology lets one observe a surge in the immune response to any external threat of illness, in those that live for others. The converse is also true.



Avoid tobacco and alcohol:



These are the two enemies of good health. There is no evidence scientifically of either of these helping man in any way, although an attempt was made to make out a case for small amounts of alcohol helping man to avoid serious illnesses. Nothing could be farther from the truth. Although we do not have evidence to show that a very small amount of alcohol kills, there is no evidence to say that even a drop of alcohol helps the system!



WHEN TO SEE YOUR DOCTOR?



If one has a good family doctor, one does not have to worry about executive check up at all. With the slightest deviation in health it is better to ask your doctor for advice. It is better to be a hypochondriac and go to your doctor than to waste money getting yourself checked up regularly. When the family physician is good he is the best insurance for a healthy life. If you are a heavy alcoholic or a smoker you have to have regular check up, as you would not be able to detect minor variations in your daily life. The threshold for minor symptoms would be very high in smokers and alcoholics; the latter might even work like a mild tranquilizer masking early symptoms of disease.



One has to see the family doctor under the following circumstances without losing precious time.

* Any abnormal bleeding from any source.

* Headaches that last for a more than a day.

* Headache with blurred vision and/or vomiting.

* Intense sudden headache.

* Vertigo of any type.

* Breathing difficulty.

* Any abnormal lump in the body, painful or otherwise.

* Sudden visual changes.

* Diarrhoea that does not stop with usual precautions.

* Bloody diarrhoea.

* Fever with breathing difficulty.

* Fever with chest pain on breathing.

* Any pain in the chest with tightness in the chest.

* Sore throat that does not ease in a week’s time.

* Any ulcer that does not heal in the usual time.

* All pregnant girls must see their doctors regularly.

* Children for their immunizations.

* Animal, snake or severe insect bites.

* Sudden loss of vision, speech or use of a part of the body.

* Unusual loss of appetite lasting for more than a week.

* Unusual loss or gain of weight.

* Sexual problems.

* Pain, anywhere, that lasts for more than a few hours.

* Accidents.

* Skin lesions that do not heal within two weeks.

* Sudden change in the quantity or quality of urine.

* Cough that lasts for more than a week, especially with large spit.





Now is the time to relax. Follow all the suggestions given above and you have a fair chance that you would live well till you die. Never try to live here forever; that will not succeed.

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