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Archive for February, 2012

Do not call them mad, please!


Published in The News Blog on February 22, 2012 :http://blogs.thenews.com.pk/blogs/2012/02/22/do-not-call-them-mad-please/

When I feel feverish, lethargic, sneeze and have a runny nose, all know I suffer from common cold, and that I am infected with a virus. If I tell them that I went to see my GP and am taking meds, they all know medications will take care of me. No one will judge me. All will empathise, give an extra advice to take rest. Some will even hug me for support, without realising that I might be transferring the virus to them. Even if they get one next day, it will be just a passing mention, “Oh I too got your flu”.

If I feel low, lethargic, don’t feel happy, lose my appetite and cry for no reason, they all ‘know’ I am an ungrateful person, who has got everything from a good family to a good home to a good carrier and is still being thankless. Not many will hug me to say, Yes we know you are depressed and there has to be no reason for it. It is because of imbalance of chemicals in your brain.”

And if I tell them I am trying to help myself by going to a psychiatrist, and am on medications or psychotherapy, they would give a stunned look and say nothing. Not many will hug me or tell me “You did the right thing”.

I also know behind my back tongues will wag and eyes will roll. Some may even diagnose “I have gone mad.”

Yes they would give me advice to read scriptures to be thankful. Or to go to some Aalim or Pir and get my “nazar jhaaroed”.

According to the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders ,  almost 78 per cent of people are suffering from some kind of psychological disorder.

Indeed, 78% of us are affected with one form of psychiatric disorder or the other. It could be a mild anxiety with minor worries, on one end, to a full blown schizophrenia, on the other, where one is cut off from the reality of this world, which in medical terminology is called “loss of insight.”

However, none of them is madness. In fact there is no such thing as madness.
Going through the 954 page document, above mentioned, I did not find any mention of an ailment called ‘madness’. I even looked up into the index at the end, the  M section  began with Major Depressive Disorder, then after Mathematics disorder, the next mention was Medication induced disorder.

Thanks to the advances of medical sciences, we now know there is always a chemical basis of psychiatric diseases. This is the reason they are quite capable of being corrected by medications. Some may be completely corrected, while some partially.

Thanks also to the sophisticated PET brain scanning techniques, we can now see with our own two eyes that Depressive Disorder or Anxiety Disorders or any other psychiatric disorders are real ailments and not mere myths.

Perhaps, our scientific knowledge of psychiatric ailments needs to cross a lot more frontiers, to be able to understand and treat all these disorders more efficiently.

Exactly  as in a common cold there are triggers like exposure to cold, or exhaustion which cause them to come again, there are environmental triggers in the psychiatric disorders too—usual ones like stress, troubled relationships, or as trivial as some taunts or sometimes as subtle as winter season.

Do we ridicule those who have fever, or cancer, or diabetes or heart attack? But we do ridicule, poke fun or bad mouth about those suffering from Depressive disorders, Anxiety Disorders, Eating Disorders, ADHD , Personality Disorders or Learning Disorders etc.

We empathise with those who do have their sight, hearing or physical ability missing and often remark that nature compensates them with some other strength or skill.

Same is true of the various Psychiatric Disorders. The people affected by them are endowed with some other skills. World’s best writers are known to be Bipolar, and many of the inventors were known to have either Obsessive Compulsive Disorder or Learning Disorder.

We all love ourselves. No one wants to fall sick, whether with common cold or with depression or of any ailment, no matter how trivial.

With the statistics of 78% affected with some psychiatric disorder, we may be definitely seeing four- fifths of our near and dear ones affected by some psychiatric disorder, ranging  from a very mild to a very serious one. Some of them may be in need of a professional help too.

So next time you see anyone you would wish to label ‘mad’,  just understand them and don’t be a trigger for them to get worse.

Know that they didn’t want to be unwell either.
And please, I beg you, do not call them mad.  

Chemical basis of some mental disorders. 

P.S. This blogpost was written in response to the @ExpressTribune ‘s article:

Celebs with mental disorders: Lock up the crazy

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Beautifully meaningful


These are colourful bits with each of a unique shape, size, yet so purposeless, resembling a pile of multicoloured rubble, until….

..magic happens.

And they all   find their right roles in the right places.

Which piece fits best next to the other isn’t necessarily of the same shade or same shape.

What is worth a notice is that they are all connected to each other, someway.

What matters most is that, together, they all make a beautifully meaningful existence.

Arent we all as individuals like the first picture?

*Correction: The magic above did not happen, it was made to happen.

Tiffany lamps have always been my favorites, for they being  beautifully handcrafted, colorful pieces of art, and at the same time  so purposeful too.

P.S. This blog post was inspired by a vibrant and transparent  soul called Geetali Tare, knowing whom is so  beautifully meaningful !

Know the bitter truth of Diabetes


PART-I

The tsunami wave of diabetes mellitus and its health and economic consequences is threatening much of the world. The need to prevent and control this debilitating chronic disease is urgent, before desperation sets in.” Journal of Royal Society of medicine.


How does this  matter to us South Asians?
Indian Subcontinent (which includes India, Pakistan, Nepal, Bangladesh and Sri Lanka) is the epicentre of this Diabetic pandemic. By 2025, over 2/3rds of the diabetics would be living in our subcontinent.
Link:  http://171.66.127.115/content/100/3/115.full

How are we more vulnerable as compared to other ethnicities?
We South Asians get Diabetes:
• 10 years earlier
• At lower levels of obesity
• Suffer longer with more complications
• Have 3-8 times higher risk of dying from Diabetes than Europeans..

Why are we more vulnerable than other ethnicities?
Again the same answer as for the Heart Disease—Our genetic makeup coupled with our unhealthy lifestyle i.e. faulty diet, obesity, sedentary habits and lack of health awareness.

Can we really do anything?
Yes, research proves that we can avert or at least postpone Diabetes and improve our quality of life through various lifestyle modifications.


What should we know?
First, know that Diabetes is no more the disease of the affluent; even the poor have it.

Second, it is no more a disease of the middle aged. Diabetes Type 2 which was earlier called the Maturity onset diabetes has now been seen to occur amongst the South Asians in early 20s and many get in their 30s.

Thirdly, in order to live a life without Diabetes we need to start early and change our life style. However, it is better late than never.

PART-II

What should we do?

If you are not a Diabetic

Step 1 : Know whether you are at high risk of Diabetes Mellitus or not.

Check your risk from the risk-factors chart:

Or better see YOUR RISK OF DIABETES  from  the  Diabetic Risk Calculator at the link below.
Link:  http://www.diabetes.org/diabetes-basics/prevention/diabetes-risk-test/

(ADV*** : Dont skip this ^^ step!!)

Important: In case you are a high risk group, please consult your doctor and ask him to screen for Diabetes. He will do some blood test on you while fasting and after meals to check your blood sugar levels.

Step 2: Get more physically active :

Benefits of exercise:
• You will lose weight
• It will lower your blood sugar
• Boost your sensitivity to insulin –which will keep your blood sugar in the normal range.

More, refer to Blog 1 : https://thinkloud65.wordpress.com/2011/12/31/living-a-healthy-lifestyle/)

Step 3: Lose the extra weight.

Obesity is one of the main culprits in causing Insulin resistance and hence Diabetes- Abdominal fat is the real culprit.


Tip: If you are obese or over weight, loss of every kilo will reduce the risk by 16%. And if you lose 10% of your body weight, you will cut the risk of developing diabetes by 60%.

Step 4: Make long term dietary changes.

Add fibre to your diet. This simply means eat more of fruits, vegetables, beans, whole grains, nuts and seeds as they are rich source of fibre. 

Benefits: Fibre reduces the risk of Diabetes, of Heart disease and risk of colon cancers. They also promote weight loss.

Check Glycemic Index of the foods you eat. Choose foods with low Glycemic Index as this maintains more constant blood sugar levels.

Tip: Print out a chart of foods by Glycaemic Index and put it over the fridge, so that it is easy to refer to them while selecting food.

For more on Glycaemic Index : http://www.diabetes.ca/for-professionals/resources/nutrition/glycemic-index/

Step 5 ; Try to manage your stress:  Stress increases hormones in the body which predispose to Diabetes.

IMPORTANT NEWS: The research has shown that if one follows the above measure, at least 50 % postponement of DM is possible.

PART-III

For those who are already Diabetic

Remember:

Diabetes is a lifelong responsibility.

You may not feel unwell in the initial years but persistently raise blood sugar levels can gradually harm each and every organ of the body, more seriously the organs essential for life-heart and kidneys.

To the Diabetic, I would just give a few outline tips here, as  it is important for you to be under a regular care of a QUALIFIED DIABETOLOGIST   to manage your health:

Step 1: Make a promise to yourself that you will take care of your diabetes by being FULLY INFORMED  of the disease. (Just google ‘Diabetes Mellitus’ and there you are).

Step 2: Try to keep the blood sugar in normal range through diet,  exercise, weight control, medications and regular smedical consultations.  A normal sugar levels maintained are as good as being non diabetic.

Step 3: DIET: Diabetics should be very watchful of their calorie intake, and must take meals LOW  in SUGAR, FAT and SALT content. You must consult a DIETICIAN to make meal plan, ideally.

See  links for dietary guidance: http://www.diabetes.ca/files/JTB17x_11_CPGO3_1103.pdf

Try  this SOUTH ASIAN DIABETIC MEAL PLAN BOOK :http://www.diabetes.ca/documents/about-diabetes/Recipe_Booklet_high_res.pdf

Other SA recipes: http://www.pamf.org/southasian/healthy/recipes/

Step 4: Get blood sugars checked at regular intervals…at home and by the doctor.
Through your doctor: Make sure you have HbA1c tested every 3-6 months. The test that shows the average amount of sugar in your blood over 3 months. It tells how well you are controlling your diabetes.

An HbA1c of 6% or less is normal. See the other levels:

Home Glucose Monitoring : Home sugar testing is also important. You must have a glucometer for this.  Ask your doctor how frequently and when should you check your  blood sugar yourself at home.

Step 5: Keep your Blood Pressure and Cholesterol under control.


Step 6: Regular health checkups to assess complications of diabetes—Have your KIDNEYS, HEART, NERVES and EYE check ups EVERY YEAR .

Ask your doctor by name —> to check for COMPLICATIONS of Diabetes.

Warning*: Long periods of uncontrolled Diabetes can cause painless Heart Attack,  Kidneys to fail,  Nerves to get numb and Eyes with loss of Vision. (This is intended not to scare you, but inform you of the seriousness of the problem).

Step 7: Take care of your FEET: Diabetes causes nerve damage which can cause injuries to feet without being noticed due to loss of pain sensation.


IMPORTANT: 

  • Check your feet everyday for cuts, blisters, redness or swelling. Consult the doctor is any such thing is seen.
  • Keep the feet clean, dry and moisturized everyday to prevent any infections.

Step8: Brush your teeth and floss them everyday. Have dental checkups every year and mention to the doctor that you are a diabetic.

Step 9: Ask your doctor if you need to take a Aspirin tablet everyday to prevent heart attack and stroke.

See the benefit of aspirin in Diabetes in this link: http://www.diabeticlive.com/diabetes-101/diabetes-news/new-study-on-aspirin-and-diabetes/#.TzwKiE4gf1k

Step 10: DO NOT SMOKE as it accelerates all the diabetic complications. If you drink, do it in moderation.

Step 11: Manage  STRESS: Stress increases Blood Sugar levels , increases food indiscretions and one tends to neglect the health. Hence manage your stress smartly.

Last but not the least, maintain a sense of humor. You may not ‘delete’ Diabetes from your life but you can ‘minimize’  it by knowing and following the right steps.

🙂 

Leaving your heart prints


Valentine’s Day isn’t just about expensive gifts, teddy bears, chocolates or red roses to girlfriends. It’s about  making any of your loved ones ( whosoever they may be)  feel that they matter.

And to make anyone feel  that you care, fortunately does not take loads of money. In fact it does not  cost anything but  a tender caring heart.

I planned to write a humorous blog on the ‘extortion day’ that  men generally call Valentines day, with a few jokes.

But when a friend sent in an email mentioning about the idea of  ‘heart  prints’, it was too touching to just shoo off this day in a joke. Hence without adding any of my non serious words I share the sentimental caring words a friend wrote in her email.

Sharon  shared:
We leave fingerprints on whatever our hands touch.  On walls, on furniture, on doorknobs, dishes and books, as we touch we leave our identity.  Each day we have the wonderful opportunity to leave prints on the hearts of those who are entrusted to our care.”  

Elizabeth Barrett Browning wrote in one of her famous poems:  “How do I love thee?  Let me count the ways.”  

We might say:  “How can we touch hearts?  Show us the ways.”  

The ways that we leave heart prints can be summed up in the word LOVE.

In his meditations, St. La Salle was very fond of quoting St. Paul.  In his First Letter to Corinthians, St. Paul describes love.  He writes of a love that touches hearts.

How might we describe this love?  We might say:

“May we leave heart prints by dealing patiently with others.
May we leave heart prints by being kind to others.
May we leave heart prints by never being jealous or boastful, or arrogant or rude.
In our dealings with others, may we leave heart prints by not insisting on our own way.”
When we are not irritable or resentful or rejoice at wrong, but rejoice in the right, we leave heart prints.

So, in all of our dealings with others, let us leave heart prints.

And if someone should say: “I felt your touch,” that might be miracle enough. “

Continuing with a  serious note,  perhaps  an look of concern, a nod that we  understand,  a bend  to lend an ear,  a few words of  compassion or just a caring glance that turns a grimace into a grin  are all ways to leave heart prints.

Coming back to my not so serious  words, well I wouldn’t  leave this page without  caring  words for my  men friends  for whom this day proves to be more of an extortion day. Here goes my empathy for the impoverished pockets:

  Conversation during an expensive candle light dinner on Valentine’s Day:

Girl (blushing) : “Do you love me with all your heart and soul?”

Boy (”the bill’ on his mind): “Mmm hmm.”

Girl( flushing ): “Do you think I’m the most beautiful girl in the world?”

Boy( still thinking of the ‘ the bill’) : “Mmm hmm.”

Girl(slushing): “Do you think my cheeks are like rose petals & my eyes like gazelle’s?”

Boy( ” the bill’ thoughts persist) : “Mmm hmm.”

Girl( gushing) : “Oh dear, you say the most beautiful things in the world!”

With no  offence meant to anyone, but I hope to  leave some grins on the grimaced faces  :).

Dilemma of duty vs compassion


Having a background from the medical profession, it is not difficult to understand the dilemmas that erupt between professional ethics  and compassion, when they, at times, seem  to clash. Doctors are often accused of ‘compassion fatigue’ which I find is a completely misplaced myth.  However, at times, one’s hands are tied through requisites of an  ‘ethical’ behaviour.

This painful story also deals with the same conflict albeit in the life of a journalist.

This is a  Pulitzer Prize 1994,  winning photo taken by  Kevin Carter a South African photo journalist. The picture was clicked, in March 1993,  during a visit to the famine struck Sudan.

The picture depicts a famine stricken child being stalked by a vulture. The child is crawling towards a United Nations food camp, located a kilometer away.

He is said to have taken the picture because  it was his ‘job title’.

Soon after the picture was published in New York Times on March 26, 1993, hundreds of people from all over the globe started to inquire about the fate of the girl.

The newspaper reported: No one knows what happened to the child, including the photographer who left the scene as soon as the photo was taken.

The photographer came under  fire for being insensitive and a publication wrote:

“The man adjusting his lens to take just the right frame of her suffering, might just as well be a predator, another vulture on the scene.”

Kevin  later confided to friends that he wished he had intervened.

Journalists at the time were warned never to touch famine victims for fear of disease.

According to another photographer, Joao Silva, accompanying Kevin, they had only 30 minutes to take pictures before flying out of the area.  And according to him, Kevin was shocked to see the children of  famine for the first time and started taking pictures of the kids, as their parents were busy collecting food from the nearby food camp.

“He carefully came close to the child to take a picture of the baby with the vulture and then after taking a few shots chased away the vulture.”

Months later, and only weeks after being awarded with the Pulitzer Prize, Kevin Carter, 33, drove up to the place where he used to play as a kid, and  committed suicide.

Portions of Carter’s suicide note read:
“I am depressed … without phone … money for rent … money for child support … money for debts … money!!! … I am haunted by the vivid memories of killings and corpses and anger and pain … of starving or wounded children, of trigger-happy madmen, often police, of killer executioners…I have gone to join Ken [recently deceased colleague Ken Oosterbroek] if I am that lucky.

His story was made into a documentary ” The Death of Kevin Carter: Casualty of the Bang Bang Club ” which was nominated for the Academy Award in 1996.

A tribute to Kevin Carter : 

Sights and Sounds May Disappear, but Smell Shall Linger.


Published in TheNewsBlog February 7, 2012. http://blogs.thenews.com.pk/blogs/2012/02/07/sights-and-sounds-may-disappear-but-smell-shall-linger/


“When I miss her, I go to her closet to sense my daughter’s fragrance.” Arfa Karim‘s Mom said on her 17th birthday.

The words from the teary eyed mother gave me goose bumps.

She was certainly not talking about the perfumes that Arfa adorned, but the odour that she inherently possessed by virtue of her HLA (genetic) type. This was the smell Arfa’s mom associated her with ever since she held her in her arms soon after her birth (even though the mother may not be aware of it, consciously.)

This reminded me of a research paper I read years ago which said the first bond that a mother and child have after birth is through the sense of smell. Babies from the time of birth learn to identify their mother through a strong sense of smell. It is said that within 24 hours, a mother is able to identify her baby’s odour too. A research claims that within 50 hours, infants were able to differentiate between the smell of their mother’s nipple from that of another lactating woman. Studies have shown that when a mother’s nipple from one breast was washed off, 22 out of 30 babies chose to suckle the unwashed side, because of the familiar odour.

Little toddlers, unaware of relationships, differentiate their siblings from friends subconsciously through odours.

It is common knowledge that animals identify and claim their territory through the sense of smell. Dogs smell their masters, and cannot be deceived even by a look alike.

Each one us is endowed with a unique fragrance or scientifically an ‘odour’ type. Our smells are coded by the genes of a group of molecules called the HLA Complex. Our odour type determines the various social cues we receive in the society in the form of attractiveness, favourable or unfavourable social reactions, and even sexual arousal. Furthermore the role of pheromones, the odour producing hormones in animals and humans as a medium for sexual attraction is also well known.

In an interesting study a group of women were asked to smell men’s T-shirts and choose the odour they liked. Majority of them chose the odour type which was different from theirs, hence from a different genetic pool. Perhaps this is nature’s way to create more variation.

In another similar study, women were asked to smell men’s T-shirts and were asked to rate them according to pleasantness. The men who had infectious diseases, (most probably sexually transmitted disease’) were in more than half of the cases labelled ‘putrid’. That’s another one of nature’s ways to minimise the transmission of infections.

My kids often mention:

‘Oh this smell reminds me of Karachi’, or of Delhi or even of ‘that’ person. Though never a subject of research perhaps every place along with its unique sights and sounds, has its own distinct set of smells too. The smells could be related to its fauna or even the food habits there. My mother often remarks; ‘The soil at every place smells different while the water in every place tastes different.’

A Vietnamese friend who recently visited her native place remarked, Hanoi has its unique smell, and it’s even funny how their embassy here smelt the same. Perhaps it’s the fish sauce!

We do spend a handsome amount on buying scents. And many rich and famous spend a fortune in creating a ‘signature’ smell of their own.

Ironically the sense of smell – though a subtle and powerful sense of perception – is subconsciously the least significant in our lives. We may feel empathy for those who are deprived of a sense of sight or sound, but often either ignore or even mock those with loss of smell. Not many of us even know that some people are born with their sense of smell missing. This condition is known as Anosmia. How incomplete their lives must be. We all have experienced small periods of Anosmia or Hyposmia when our noses get blocked during the common cold. We all know how tasteless even the most delicious of foods seem, with a blocked nose. This simply reinforces the hidden fact that before actually tasting, it is the smell which judges the true taste of food.

Hence, our sense of smell and the odours of others, animate or inanimate creates a great bond and sense of belonging.

One can very well imagine how much Arfa’s Mom must be feeling the presence of Arfa in everything that is associated with her. Though Arfa’s sight and sound may have left, her smell shall linger in the place and possessions she has left behind.

Painfully Humane


Published in TheNewsBlog on January 31, 2012. http://blogs.thenews.com.pk/blogs/2012/01/31/painfully-humane/

A couple of days ago I met a neighbour outside the house, walking her two cute cocker spaniels. We exchanged New Year Greetings and as a ritual I asked: “So how did you spend your new years eve?”

“Oh I spent my evening feasting with my girls.” she replied

“Lovely, so they all came over to be with you.”

Her face changed color, “Oh no, these girls Sasha and Mori pointing at the two cocker spaniels, picking up the little ones in her arms.

Embarrassed I replied: “Yeah couldn’t be a better new years eve than with one’s pets. I did it too, when the rest of my family went to see the fireworks at midnight, I sat with my cats on the sofa watching TV.”

This triggered off the talk on how we undermine animals and use terms like ‘animal’ or ‘beast’ with a derogatory hint while using words like ‘humane’ as a symbol of compassion.

“I see those TV anchors calling suicide bombs that go off in Pakistan as ‘inhumane’ acts, when in reality they’ve been done by humans themselves, especially those who aspire to be superhuman so that they get a special place in Paradise.”

I could just nod in agreement.

She went on, “Isn’t this all very ‘human’ to kill, for no rhyme or reason?”

Her words echoed for hours. Don’t we use the same terms ‘insaniyat’ for compassion while ‘janwar’ or ‘haiwaaniyat’ for cruelty in Urdu too.

Although, it is common knowledge that even the most dangerous of animals do not harm unless they are hungry or provoked.

Perhaps our ‘hunger’ has gone beyond filling our stomachs. We ‘attack’ others to fill our egos, the egos which never get filled, because there is no bottom. Yes no bottom, because, we do not have any limit to how low we can stoop to gratify our egos.

Often we see and hear of stories where two pets that could have naturally been predator-prey, coexist as friends and in fact the predator acts as a protector of its erstwhile prey.

I saw this live for years in my own home between our cat Nelson and the grey parrot Shakespeare. Shakespeare learnt to mimic the mewing and growl of Nelson. And Nelson would come running to him. They would simply mew, looking into each other’s eyes. No t even once did the cat attempt to attack or touch the grey parrot. The day Nelson passed away and went missing from home, Shakespeare mewed for hours, as if calling out for him, adding to the gloom and shedding tears like a bereaved kid.

It is a bigoted myth that empathy is a higher cognitive function that only apes and humans are blessed with. Perhaps we are more loaded with narcissism than with empathy. Studies on whales show they are extremely emotional. Whale brains have specialised spindle cells which are important for empathy, and rapid gut reactions. Previously, only humans and apes were considered to possess them. An interesting practical example of this is when a 50-foot, 50-ton humpback whale was caught in a net off California’s coast. After rescuers untangled it, the whale swam up to each one of the rescuers, and winked before swimming off. The researchers confirmed this was a gesture of gratitude from the whale.

To study empathy, neuroscientists in McGill University injected acetic acid in the paws of mice causing them pain. The mice who watched their friend writhing in pain became more sensitive and reacted more violently to pain, when injected with the same chemical.

Studies on animals called ‘humans’ show that children who are cruel to animals, are likely to turn to violence later in life. 75% of prison inmates are known to have past history of animal cruelty, says a study.

We need to revisit or swap the meanings of ‘humane’ and ‘beastial’, or ‘insaniyat’ and ‘haiwaniyat’.

It is a saving grace that we do not understand animal language, otherwise it would be very embarrassing to know that every time a suicide bomb, target killing or even animal poaching occurs we would have heard animals scream “What a painfully humane act!”