Category: Medicine Hat News

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New Year’s Resolution

Ring out the old, ring in the new,
Ring, happy bells, across the snow:
The year is going, let him go;
Ring out the false, ring in the true.

-Lord Alfred Tennyson (1809-1892)

Somebody asked me the other day, “Eh, doc, what is going to be your new year’s resolution?”

“Good question, I haven’t given it a thought yet!” I replied.

Then came an e-mail from a gentleman who wants to meet with me. He liked my column titled “Walking and my Grandma”. He wants me to take this subject one step further.

So, I met him last week. His name is Rob Gardner. He is a soft spoken, persuasive, enthusiastic, Community Education Coordinator for Canadian Diabetic Association (CDA). Currently, he is enrolling Medicine Hatters into CDA’s diabetes prevention program called “Keep Your Body in Check.”

“Rob”, I asked, “why do I need to enroll in this program? I don’t have diabetes.”

Gently, he put a small colorful flyer on my hands. He said, “Doc, this was mailed to everybody in Medicine Hat. Did you get one?” I could not recollect getting one. Have you looked at all the flyers which have come to your mail box this month? I haven’t!

Rob asked me to look at the question on the other side of the flyer. The question is: Are you at risk for type 2 diabetes?

The pamphlet says yes, I am at risk for type 2 diabetes if I am over 40, overweight (especially around my middle), or am of aboriginal, Hispanic, Asian, south Asian or African descent.

Yes, I am at risk if I have a parent or sibling with diabetes, if I have high cholesterol level, or I have high blood pressure or heart disease.

Yes, I am at high risk if I have given birth to a baby over four kilograms or had gestational diabetes.

I realized immediately that I had more than one risk factor for type 2 diabetes. I didn’t have to be a rocket scientist to know that. So, I enrolled in the diabetes prevention program.

Just like a good Santa, Rob gave me a box full of goodies – all free. Like an excited little boy, I opened the box. I was pleasantly surprised to see a pedometer (step counter), with a log book, a nice t-shirt, and a measuring tape to measure my waist. All free!

So, I knew what my New Year’s resolution was going to be – to keep my body in check and prevent type 2 diabetes. You can do the same, whether or not you have any risk factors. It is a good program to stay healthy. It is very easy to enroll and the gift box will arrive by mail. Use one of the following options to enroll:

-toll free number 1-866-533-7462 or
-the website www.keepincheck.ca or
-phone Rob Gardner at 403-529-4729 or
-e-mail him at rob.gardner@diabetes.ca

Mention that you read about this program in “What’s up doc?” column then Rob will give you an extra gift! Unfortunately, this program is only for people with Medicine Hat postal code. So, hurry up!

In case you missed my column, “Walking and my Grandma” then you can find it on my website: www.nbharwani.com and search under “Articles” or phone my office 527-0099 for a copy. In 2005, this column will run on Tuesdays.

Have a happy and wonderful 2005. And don’t forget Rob Gardner and keep your body in check!

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Looking Back to 2004

If you believe the doctors, nothing is wholesome:
If you believe the theologians, nothing is innocent:
If you believe the soldiers, nothing is safe.
Lord Salisbury – (1830-1903).

It is time to look back to 2004.

Most of us are worried about our health. What did 2004 do for us? Did we make any significant gains to achieve good health? Did medical science make any progress in that direction?

Viox has gone off the shelves after initially being promoted as the magic drug. Looks like Celebrex and other painkillers will go the same way. These events remind us once again that medicine is an imperfect science, clouded with uncertainties

We have experts in all kinds of fields. But experience of life teaches us that we should be careful of what the experts have to say. An article in the British Medical Journal (BMJ) says, “Despite the exponential growth of medical information, the effects of healthcare interventions are often uncertain or controversial.”

I cannot recollect any major scientific breakthrough this year that changed medical practice in a positive way. Most headlines related to medical practice were of negative nature – withdrawal of Viox, outbreak of diarrhea in Calgary and Montreal, shortage of flu vaccine in US etc.

We continue to fight the old battles against obesity (including trans-fatty acids), smoking, cancer, heart disease and trauma. These are the big five causes of most diseases and disabilities in our society. This has not changed in 2004.

The editors of the journal Science have put out a list of top 10 scientific achievements of 2004. But the list does not contain any medical breakthrough to improve our health in the immediate future. For example, here are the top three scientific achievements of 2004:

The most important scientific achievement was the landing and discovery of water on Mars by NASA’s two rovers, Opportunity and Spirit.
The second was the discovery on the Indonesian island of Flores of fossils from a species of tiny humans. These humans were one meter tall with a brain less than one-third the size of modern humans. They lived about 18,000 years ago.

Third most important scientific achievement was the cloning of human embryos by South Korean researcher Woo San-hwang and his colleagues.

Why progress in medicine is so slow?

According to the BMJ article the major hidden barriers to better health care:

-uncertainty as a result of lack of convincing evidence because of delayed or obsolete data from clinical studies;

-uncertainty about applicability of evidence from research to the patient’s bedside;

-and uncertainty about interpretation of data.

Because of these uncertainties, there is overuse, misuse and sometimes underuse of medical technology with associated errors. Patients undergo excessive investigations and sometimes inappropriate treatment.

The BMJ article asks, “Can the fog that enshrouds the medical practice be lifted?”

Yes, the article says, if we can find evidence that is judged to be important for practicing doctors. Unfortunately, most existing evidence is irrelevant or unreliable.

Yes, if we can train doctors to make decisions under uncertainty.

Yes, if our leaders and the public understand the inherent limitations of medical knowledge and the role of research in reducing uncertainty.

Unfortunately, uncertainty influences virtually all of medical decision making. And this has not changed in 2004. So, we just have to keep fighting the old battles!

Thought for the week:
To like and dislike the same things, that is indeed true friendship.
-Sallust 86-34 BC

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Christmas, Religion, and Health

“Religion is a way of walking, not a way of talking.”

William R. Inge (1868-1957)

Christmas is almost here and that gives me a chance to talk about religion.

I have lived in four continents and I have spent most of my adult life amongst people of different religions. I agree with Robert Burton (1577-1640), who said, “One religion is as true as another.” All religions teach the same virtues – forgiveness, kindness and generosity.

If one religion is as true as another then why do we need so many labels? Benjamin Disraeli (1804-1881) said that sensible men are all of the same religion. And what religion is that? Sensible men never tell!

But the current world atmosphere makes it difficult not to talk about one’s religion. Look at the politicians in this country and the USA. Religious beliefs come up for discussion all the time. Elections are fought and won on what is religiously right. It seems our values and politics are judged on the basis of our religion. There is no end to stereotyping.

What I don’t understand is why it is necessary for a sensible man to talk about his religion in public? Here, I agree with Sean O’Casey (1880-1964), who said “I think we ought to have as great a regard for religion as we can, so as to keep it out of as many things as possible.” To this I would add, let common sense prevail so that society can be just and kind.

Every religion has its share of bigots, zealots and fanatics. This is not something new. It’s been there for centuries. These people promote their brand of religious beliefs which promote divisions and hatred rather than forgiveness, kindness and generosity.

But I believe the vast majority of people (whatever their religion) use religion and spiritualism to promote good health, happiness and brotherhood of man. It is used to achieve peace and tranquility in life.

Sigmund Freud (1856-1939) said, “Life as we find it is too hard for us; it entails too much pain, too many disappointments, and impossible tasks. We cannot do without palliative remedies.” Unfortunately, religion is not what he had in mind when he suggested palliative remedies. In fact, he said that when a man is freed of religion, he has a better chance to live a normal and wholesome life.

Now, some people would agree with that. Since every religion imposes on its followers certain type of discipline. Some religions are more rigid than others. But many people find common sense flexibility more attractive than dogmatic rigidity.

Most sensible people carry on life the way they feel is best for them and their families, in a quite way, without making waves or hurting anybody’s feelings. After all one’s religion should be something very personal. Many people find happiness and comfort in religious activities in a quite way. And that is good. The happier you are, the healthier you feel.

Remember what George Bernard Shaw (1856-1950) said, “There is only one religion, though there are a hundred versions of it.” Let us respect them all so we can do unto others what we like done to us.

Merry Christmas and a safe holiday season.


Thought for Christmas:


At Christmas play and make good cheer,
For Christmas comes but once a year.
Thomas Tusser (1524-1580)

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Staying Healthy

Dear Dr. B: How do I know I am healthy? And how can I stay healthy?

This is a good question for the month of December. This is a month when most people are not worried about their health. It’s a month to shop, eat, drink and be merry. After all Christmas and New Year come only once a year.

But many people use December as a time to reflect on the year gone by and plan for the year to come by. It may be about health or about other matters. It is a good month to remind oneself to get a yearly physical examination and blood tests. And pay a visit to your doctor and ask, “Doc, am I healthy?”

“Yes,” he will say, “you are healthy if you are maintaining a healthy weight, eating right, staying physically active, not smoking, controlling your blood pressure and cholesterol levels, and if you are a diabetic then you should be controlling your blood sugar level.”

This is a bit simplistic answer but you get the point. Many factors determine good health. Maintaining good weight is important. We know that being overweight increases the risk of heart disease, diabetes, high blood pressure and cancer.

But how does one know if a person is of normal weight?

Recently the Canadian Medical Association Journal (CMAJ), published the 2003 Canadian Guidelines for Body Weight Classification in Adults which updates the weight classification system that had been in use since 1988.

The authors of the article say that although the guidelines are helpful, the absence of concrete answers to relevant clinical scenarios weakens their practical application, and they should be applied with caution. After all they are only guidelines. These guidelines should be used in conjunction with clinical findings.

The body weight classification depends on the body mass index (BMI) – kg/m2 . There are many sites on the internet were you can enter your height and weight and your BMI will be calculated for you.

You are considered underweight if your BMI is lower than 18.5 kg/m2 . This could be a marker of malnutrition or may identify people with eating disorders.

If your BMI is between 18.5 and 24.9 kg/m2 then this is considered normal and good weight for most people.

Overweight is defined as a BMI between 25 and 30 kg/m2. This is associated with increased health risks and may lead to health problems in some people. The authors say that many factors beyond BMI influence health risk, such as body fat distribution, physical activity, diet and genetic background.

Obesity is defined as an excessive accumulation of body fat. The BMI of over 30 is considered to be obese. These individuals have increased risk of health problems.

Waist circumference is also important. Healthy waist circumference in a male should be less than 102 cm and for females less than 88 cm.

World Health Organization says that in the most industrialized countries at least one-third of all disease burden is caused by tobacco, alcohol, blood pressure, cholesterol and obesity. So, if we want to stay healthy then we need to tackle these problems.

Healthy eating and maintaining a healthy body weight are the first steps in that direction!

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