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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

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!”

Daring to cross the love border


Published in Aman Ki Asha, The News on January 24, 2012.

Ilmana Fasih shares some stories of building cross-border bridges through the social media

A world without borders was my childhood dream. The desperation and the need for this dream to realise, came out in the open when I embarked on my ‘pyar border paar’ journey, after deciding to tie the knot across the border. I’ve been on two decades of a topsy-turvy ride riddled with visa travails, with the hope-hopelessness cycle going round in vicious circles. Not had I ever dreamt in my wildest of dreams that my hope for a borderless world could be realised in my lifetime. By a ‘borderless’ world, I mean erasing psychological rather than physical borders.

Perhaps on ground it still remains a dream, but on the virtual terrain it has turned into a reality, with the booming world of social media, especially twitter. It is a visa free, passport free utopia where no one is asked their colour, creed or credentials.
It does not take long for one to get addicted to this borderless terrain. The most fascinating thing for me is to see Indo-Pak friendships burgeoning through social media. Thanks to this factor, we can all be a family beyond borders and beliefs, tied with passions common on both sides of the Indo-Pak border.


Indians and Pakistanis wish each other on Eid and Diwali via Twitter and Facebook, and send virtual firecrackers, mithai and biryani across the border.
The #shair hashtag which ‘trended’ on twitter some time back merits a mention. Every day, it attracts Urdu poetry loving twitterati in India and Pakistan. As Rana Safvi , who started this trend, begins to tweet the topic or the poet of the day, other #shair fans start to contribute their tweets with unmatched enthusiasm. So common is the passion for #shair on both sides, that it is almost impossible to identify which side of the border the tweep belongs to.
Rana tweets: “Twitter ne nikamma ker dia, warna aadmi hum bhi aadmi the kaam ke.” #shair
Comes the reply: “140 characters mein baat ker lete hain, DP to DP borderpaar, mulaqat samajh lete hain.
Political differences and arguments also emerge on twitter, but more than anger, what trumps are the vibes of friendship and harmony. The same thrill is felt on facebook too, with some limitations.
Some time back I was approached by two sets of people keen to tell their story of cross-border friendship developed through social media.
One was Ram, a boy in his mid twenties, from West Bengal, India who became friends with Maria, a girl in Punjab, Pakistan through facebook. As their friendship led to a better understanding and respect for each other’s cultures and beliefs, the vibes spilled over to thaw any cold feelings that their families had for the other side. When Ram’s father fell ill and was admitted to hospital, Maria’s mother and sister prayed for his recovery. He recovered, and Ram’s family attributed the recovery to Maria’s family’s prayers (duas).
Now, as Maria is about to be married, Ram’s family is sending her a present as a token of their friendship and gratitude for her family’s prayers. Ram explained that their families had no links to anyone the other side, and hence had no other reason to be warm, but for their friendship.
Maria and Ram have vowed to keep up their friendship even getting married to their respective spouses, and one day, when they can obtain visas, they hope to meet and ensure that any children they have are able to meet each other.


The second story is that of a love-struck couple who prefers to keep their identity and respective nationalities confidential. They contacted me with a request that I should intervene, (having gone through a similar ordeal), and convince the girl’s parents that tying a knot across the border can work out.
Like many others, they ‘met’ through an incidental chat on twitter some six months ago. They then added each other as friends on facebook. The exchange of pictures and other information led them to develop a better understanding of each other, until they reached a point when they decided they needed to share their lives. Both are in their early or mid twenties, and feel they are mature enough to embark on this journey.
The hope and enthusiasm that they had attached to my help made it hard for me to explain that I would prefer to stay away, and that they needed to deal with the situation themselves. Life is as such a struggle, and with a cross-border union, it gets tougher. Hence, let this be the first hurdle they need to cross together, before embarking on the real lifelong journey.
The couple cited the Shoaib Akhtar-Sania Mirza marriage as an example, but the girl’s parents pointed out that they were ordinary people, not stars. Hence they chose me, an ordinary Indian woman married to an ordinary Pakistani man to plead their case.
With this borderless world of twitter and face book, it is easy to predict that in future, there will be more virtual friendships which people will want to turn into real relationships.
As I explained to them, I would want everyone to appreciate that such decisions are never taken either in a haste or without realising the pros and cons of this life changing decision. Life is tough in any case, it gets tougher, and more so, after an Indo-Pak adventure. Since there are decisions which when taken can effectively be non-reversible. The decision of one of the spouses to forego his or her passport for the other side cannot be reversed, whether the marriage works or not. Secondly, when the couple has children, their nationality is one or the other. So if the marriage fails, the woman may have to suffer a lot in terms of losing her children, if the children happen to have the father’s nationality (or vice versa).
I have personally seen a couple of cases in which things did not work out and the mother and children were left stranded across the border, unable to meet again at all. I also know a woman, who is bearing all her husband’s abuses including his second marriage, only because she does not want to lose the children who have the father’s nationality. Moreover, her children are very young, and she can’t think of separation, as she has no family support or financial standing in her husband’s country, for which she left her own.
All this is certainly not intended to dissuade anyone from daring to cross the love border. But those who think of it should be fully informed of all the issues involved before embarking on this toughest exam of one’s real life.
The young twitter couple I mentioned is adamant that they want to tie the knot and transition their relationship from the virtual to the real world. I wish them good luck in their future journey.

The writer is an Indian gynaecologist and health activist married to a Pakistani. She blogs at
//thinkloud 65.wordpress.com/

Love your Heart to Live


Please read this very carefully.

A large study from McMaster University Canada, and some researches in India and Pakistan have come to a know that:
• We the South Asians have 5-6 times higher risk of Coronary Heart Disease than Europeans, Africans or other ethnic populations
• The Heart disease in South Asians occurs at a premature age ( below 40 years of age) and are at a younger age group at the time of Hospitalisation.
• We the South Asians by the virtue of our genes are predisposed to Heart disease which then gets compounded by our un healthy lifestyle.
• The South Asians also have a higher incidence of Diabetes, High Blood Pressure and High Cholesterol levels as compared to other communities.

What exactly happens in a coronary heart disease?

The heart muscle which works every second of our life, is supplied oxygen by coronary arteries. As the ageing occurs or due to excess fat or smoking or other reasons the fat starts to deposit causing the arteries to narrow down. As a result the blood supply to the heart decreases.
In situations like stress or heavy work, when heart muscles need more oxygen, the inadequate supply cause chest pain. This pain is called angina. If a person rests, this can be reversed.
If this lack of oxygen is prolonged it leads to permanent damage to the heart muscle which we call Heart attack ( medical name  is   Myocardial Infarction).

We often hear others talking of percent block in the heart arteries. It simply describes to what extent the heart coronaries are blocked, as shown in the picture.

The same mechanism occurs in the brain, when the brain arteries get narrowed down by the same reasons. This damage to the brain leads to stroke.

How do we know if it is a heart attack?

The symptoms of heart attack can vary. The typical symptoms are given as in the picture below:

And…

However there could be unusual signs too.

Anxiety, denial or even the thought that ‘it could be a heart attack’ can be a symptom.

Hence anytime you feel unwell, and your inner voice calls for a fear, don’t delay and consult a doctor immediately.

Why do we need to worry about the heart disease?

Heart disease medically known as Ischaemic Heart Disease is the top killer for the people in South Asia.

Audio in Urdu/Hindi Part 1: 

What should we do to prevent Heart disease?

We cannot change our ethnicity, age, gender, Family history.
But then the good news is that there are certain factors which we can modify, so that we can minimise the chances of developing this problem, early in our life. The studies have proven that if we follow a healthy life style, we may be able to delay these problems by as much as 10 to 15 years.

The preventive steps to be taken are in fact a repeat of the steps in Health Living blog.

Step 1:  Be physically active—We need minimum of 30 min of exercise each day or 150 min of moderate exercise at least 5 days a week to keep the heart fit.

You should know what should be your target heart rate while doing different types of activities. You gain the most benefits and lessen the risks when you exercise in your target heart rate zone.
(For more details about your target heart rate related to the type of exercise can be seen in this link: http://getfitwithval.com/target-heart-rate-chart/)

Step 2: Maintain a healthy weight and waist circumference.


We discussed Weight and importance of BMI in previous blog >> Living a healthy lifestyle. 

Two recent studies have found that to asses one’s risk of Heart Disease the best measure is the ‘ waist circumference’.
(One of the reasons for using waist circumference is that it directly measures increased fat mass around your organs, fat known as visceral fat.)

Please note below the normal limits waist circumference in our South Asian men and women.  And also not that we need to have them less than the other ethnicities to keep healthy.
Waist circumference               Men                                                     Women

South Asian heritage             90cms                                                  80cms
Caucasians, Africans              104cms                                               90cms

See the video to learn how to measure the waist circumference accurately:
(For details of weight BMI refer to the previous blog on healthy living)

Step 3: Eat a healthy low fat diet: Our second blog was all about healthy eating. Please refer to the blog >> Eating your way to good health.

Step 4: Know and control your Blood Pressure

Do you know what your BP, last measured is?

Do you know what the normal range of Blood Pressure is?

It is important to check BP regularly and ask the doctor how much was the reading, and preferably note it down on a card. So that when it is repeated, you can compare from the previous reading.

An ideal BP must be below 140/90 mmHg.

Above this will cause more effort for the heart muscles to pump the blood through the arteries.

The picture below shows the BP measuring instrument and some basics on Bloos pressure measurement.

Caution: Thanks to another doctor friend, Kavita Desai’s reminder, it is very important to understand that if you measure it at home, the correct method to record accurate Blood Pressure should be learnt.You can learn it from your doctor, hands on or check on the net. (Please refer to the link in the comment box for it).

In case the blood pressure is  different, you must know what are the range of abnormal readings and the terms used for them.

In case your Blood Pressure is high you must consult  a specialist to get it in control either by Lifestyle change, or by medication. Do not be apprehensive of BP medication if you are advised.

Myth: It is a myth that BP medications are harmful.
Fact: In fact blood pressure if not controlled is more harmful and can cause damage to kidneys, eyes and even lead to brain haemorrhage.

T o keep the BP in control, limit the intake of salt too.( The daily allowance of salt is 2300mg=1tsp salt).

Step 5: Know and control your Cholesterol

Do you know what your total cholesterol level is?

Do you know it is important to know the LDL ( bad cholesterol) and HDL( good cholesterol) levels too?

There are two kinds of fat:
Saturated fats are not heart healthy, since they are most known for raising your LDL cholesterol (“bad” cholesterol).
Unsaturated fats are heart-healthy fats – they have the ability to lower LDL cholesterol and raise HDL cholesterol (“good” cholesterol).

Cholesterol levels are generally related to our diet intake.  But South Asians have cholesterol problems which run in families called as familial Hyperlipidemias.

Hence get your cholesterol check regularly from an early age and keep it under control through life style change or through medication under Doctor’s supervision.

Exercise help reduce bad cholesterol and raises good cholesterol.

Do you know that the oils you use can contain different proportions of saturated and unsaturated fats?

The more the unsaturated fat,  the healthier is the oil.

Please decide for yourself which oils are the best for heart health:

Step 6: If you are a Diabetic manage and keep in control your Blood Sugar levels.

Diabetes causes hardening of the arteries (atherosclerosis). And hence can damage the arteries of the heart too. The nerves also get damaged, so when a diabetic gets heart attack, may be without any pain symptoms known as silent heart attack.

It is very important that if you are diabetic, to keep the blood sugar under control and know that poor control can lead to heart, kidney and other problems

( A detail on DM will follow next ).

Step 7: Cut down on unhealthy habits:

  • Reduce your Alcohol intake
  • Stop smoking as smoking causes heart vessels to get brittle and hence early heart attacks
  • Stress also raises blood pressure and heart disease.

A rigorous effort to maintain these steps can help reduce the chances of heart disease and delay by 10-15 years.

Don’t delay:  Please be sure of the symptoms of heart disease, and even if you are lean and thin, or have no previous symptoms.  If chest pain or any other symptoms occur, or even if you just fear it could be heart attack,  do not delay medical advice.

It may not be serious, but if it is timely check up, it can save life.

So please stay fit, active , eat healthy and be stress free to minimize your risk of a heart attack.

If you love quality life, love and take care of your HEART ❤

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