Author: noorali

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How Do You Know If You Are Depressed?

The other day I was talking to a lady who said that she was on the verge of depression. She said, “I am not there but I am close.”

“Depression is a major public health problem, which is predicted to be second only to cardiovascular disease as the leading cause of disease-related disability worldwide by 2020,” says an article in the Canadian Medical Association Journal (CMAJ).

The article laments that depression goes unrecognized and poorly treated because physicians are too busy dealing with physical ailments and have no time for mental health care. There is stigma attached to diagnoses of mental illness so patients are in denial for a long time. Lastly, there is uncertainty about treatment efficacy and patients sometimes feel poorly treated.

Amongst teenagers, depression is a very common problem and affects as many as one in eight teenagers. Just like in adults, depression amongst teenagers affects more girls than boys.

Why does one feel helpless and depressed?

There isn’t one single factor that makes a person feel anxious and depressed. Some of the factors which influence how you feel depend on genetics, environment, other medical conditions and events which have occurred in your life and how you react to them.

In western countries, our lifestyle plays a significant role in causing depression. Some of the lifestyle factors are: our constant desire to get rich and acquire materialistic things, our desire to achieve success as defined by our peers rather than our desire to achieve happiness and the ever changing world economics make our job and financial well being insecure.

How can one know that he or she is on the verge of depression?

Life is not fair. There is stress and there is sadness. If the feeling of sadness lingers on and interferes with your ability to participate in normal activities then you know it is a warning sign, either you are depressed or you are on the verge of depression. You need to seek help immediately.

How does one feel if he or she was depressed?

There are various symptoms of depression. For example a person feels sad most of the time (sometimes for no obvious reasons), there is lack of energy, there is inability to enjoy things that used to bring pleasure, you tend to withdraw from friends and family, there is easy irritability, anger, or anxiety, you are unable to concentrate, there may be significant weight gain or loss, there is significant change in sleep patterns, there is feelings of guilt or worthlessness, there is pessimism and indifference, and there are thoughts of death or suicide

If you think you were on the verge of depression then what can you do to get back to “normal”?

Immediately get help from your family doctor. It is as simple as that. It is important to find happiness in life. Happy people live longer, give more, have more energy, are more likely to get married and people generally like to be around happy people rather than people who constantly complain of life’s little or big discomforts.

There are many books written about happiness. That means there is no easy solution to finding happiness. But some of the things you can do to be happy are: practice act of kindness, express gratitude, cultivate optimism, avoid over thinking, learn to forgive, develop social skills, do not depend on others and thank heavens for glass half full rather than half empty.

Do I see you smiling? Well, half the battle is already won!

Start reading the preview of my book A Doctor's Journey for free on Amazon. Available on Kindle for $2.99!

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Euthanasia vs. The Power of Prayer

Terminal care is physically demanding and emotionally nerve wracking. Most families have had the experience of dealing with a family member or a relative who was dying of an incurable illness. They see the ill person suffer from pain, pneumonia, urinary tract infection, back pain, bed sores, sleepless nights, shortness of breath, bowel obstruction, stomach tube, constipation, enemas, multiple pills, multiple injections, confusion, delirium, fear, anxiety, depression …the list goes on and on.

My mother’s last few weeks in this world were no different.

She knew she was going to die. In her room, in a Calgary hospice, she wanted the clock on the wall where she could see the time clearly. During the day, she would ask, “How come the time is moving so slowly?” In the silence of the night, I wondered if she could hear the clock tick telling her that although her time was up, she will have to wait for her turn to die.

The place of her death was already decided, it was not going to be her home in Calgary. Her wish to die at home could not be fulfilled because, after four months of gradual deterioration in her health, the nursing care provided by the members of her large family came to an end when they were physically and emotionally exhausted. The family was rescued by the wonderful people at Home Care, Palliative Care, Foothills Hospital and Agape Hospice.

Now, who was going to decide on the timing of her death?

My mother was a deeply religious woman. She believed in the power of prayer and prayed very hard to God to end her life and stop the misery of pain and indignity. She requested all her visitors and family members to pray for her quick end. During her better days she used to ask me to promise her that I, as her physician-son, would not let her suffer if she was terminally ill and in pain. She wanted me to end her life with some medications. I explained to her that such actions were not legal in this country.

When she was diagnosed with terminal gynecologic cancer, she reminded me of our discussion about euthanasia. When she was in the hospice suffering, I felt she was a right candidate for euthanasia. In the last few days of her life she could not find a comfortable position in bed. She could not get out of bed and she had lost control of her bodily functions. She could not breathe comfortably.

The slowly growing pelvic tumor had made her abdomen very large and eaten away all her body fat and had wasted all her muscles. She had quit eating due to constant nausea and abdominal fullness. She was weak and frail. Every movement was painful.

Lately, she was sleeping a lot with the help of morphine. Each day there were few hours of bright moments. She would watch her favourite television shows. She would listen to her favourite religious songs. She enjoyed all the visits and phone calls she received from friends and relatives locally and from all over the world. Her memory never lost her but her hearing gradually got worse and her voice gradually got weaker. The end was near.

Finally, her prayers were answered. Her role as a wife, mother, grandmother, great grandmother and great great grandmother came to an end at 7.40 p.m. on Saturday April 19, 2008 in the presence of family members. It was end of an era. She was the matriarch of the family. At 87, she was the last surviving member of her and my dad’s siblings.

The power of prayer had won.

Start reading the preview of my book A Doctor's Journey for free on Amazon. Available on Kindle for $2.99!

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An Island for Good Health and Happiness

Spring is here and it is time to take stock of our health. During Christmas and New Year, most of us make resolutions or think of things to do in the next 365 days. We are all in search of good health and happiness. And I am no different. Everything I do is in some ways related to my search for that elusive nirvana.

Like most people, I found last winter to be severe. An empty nest at home does not help. And my frequent trips to Calgary to see my terminally ill mother added extra pressure on my mental and physical well being. Now I understand and appreciate why some people go south to warm weather for three to six months. It is good for sanity. Currently, I am in no situation to take that amount of time off. So I tried to take frequent breaks during the winter months.

I had a good holiday with my family in Disneyland. I also went to Antigua with my son Hussein to check out his university (American University of Antigua College of Medicine), play some golf with him and relax on the beach. They have 365 beaches – one for each day of the year! Since our house is an equal opportunity residence, it was fair to visit my daughter, Alia, at the University of Victoria and take her to Seattle for the long weekend in Easter. This is good for keeping the sibling rivalry at bay – so to speak.

My wife was not to be left out. So I took her to Las Vegas for our 25th wedding anniversary on April Fools Day. After 25 years, she still thinks our marriage is real! It is hard to convince people that we got married on April Fool’s day. On April first, as part of our celebration, we attended a show in Las Vegas (Cirque du Soleil’s Zumanity). We were called on to the stage as we were the only couple in the packed theatre who was married on April Fool’s day and was still together after 25 years! That was our 15 minutes of fame.

Antigua (pronounced an-TEE-gah) is a beautiful island in the West Indies. It has a circumference of 87 kilometers. It has a population of about 70,000. According to Wikipedia, it is the largest of the Leeward Islands, and the most developed and prosperous due to its upscale tourism industry, offshore banking, internet gambling services and education services, including two medical schools.

The capital city is St. John with a population of 30,000. The island has an international airport (VC Bird International Airport) which is serviced by many major airlines including Air Canada. It has deep harbour to accommodate large cruise ships. It has 365 beautiful beaches (one for each day of the year) and tropical marine weather to go with it. The island is internationally famous for yachting and sailing. It has two 18-hole golf courses and they charge US$40 for green fees and US$30 for power cart. The Antiguan currency is the Eastern Caribbean Dollar. Suggested exchange rate is EC $2.60 to U.S. $1.00

Antigua is a beautiful island where you can find excellent bars, music, beaches and food with peace and tranquility. It is a slow paced island requiring patience for pleasure and happiness. I am glad I went there. Now I have to work on getting 20 lbs. off my bulging belly so I can find my golf balls! You get the point. Cheers.

Start reading the preview of my book A Doctor's Journey for free on Amazon. Available on Kindle for $2.99!

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Vaccination for Adults

When you are a child, quite often you don’t have a choice. You have to get immunized against various disabling and life threatening illnesses. When you become an adult, you are too busy making a living and raising a family. You don’t think about immunization unless somebody reminds you or if you have to travel outside the country.

A website on immunization says, “Getting immunized is a lifelong, life-protecting job. You’re never too old to get immunized.”

There is a long list of adult immunization vaccines. Here is the list – influenza, Pneumococcal, tetanus, diphtheria, pertussis (Td, Tdap), hepatitis B (HepB), hepatitis A (HepA), human papillomavirus (HPV), measles, mumps, rubella (MMR), varicella (Chickenpox), meningococcal and zoster (shingles). For more information you should talk to somebody in the health unit or visit www.vaccineinformation.org

If you are planning to travel outside Canada, then your need for vaccination will depend on your destination and environmental conditions prevalent in that part of the world. The standard of hygiene, the quality of food and water will determine what kind of illness is prevalent in that country. At home or in foreign countries careful selection and handling of food and water will prevent many illnesses.

You should consult your local health unit three months before your date of travel to get all the information about your vaccination needs. This will give you enough time to complete the immunization schedule. A listing of travel clinics across Canada can be found at the Public Health Agency of Canada’s Travel Medicine Program at www.travelhealth.gc.ca.

It is estimated that two million Canadians will travel this year to developing countries. Many of these Canadians will be returning to their land of origin to meet friends and families. Many Canadians go overseas as volunteers to the world’s poorest people to help build houses or work in their hospitals or orphanages.

Studies have shown that 75 per cent of people who go abroad develop some kind of travel-related illnesses affecting their stomach or bowel, dengue fever, malaria and typhoid fever. These are just a few examples. It is also unfortunate that only 15 per cent of international travelers visit travel health clinics before they go abroad. Why?

Cost of vaccinations is one of the main reasons why many people avoid immunization. An article in the Canadian Medical Association Journal (CMAJ) says that a family of four going to a yellow fever zone in West Africa for one month would need to spend at least $1900 on vaccines alone. So what happens? Eighty five per cent of travelers avoid spending that kind of money. Hence they return to Canada with travel-related illnesses. The cost of treating these patients in our health care institutions costs millions of dollars. Would it be cheaper for provincial governments to provide vaccinations free? That is a question that needs to be considered by the provincial governments. In the mean time if you are planning to go abroad, make sure you budget for travel related vaccinations.

Start reading the preview of my book A Doctor's Journey for free on Amazon. Available on Kindle for $2.99!