Category: Medicine Hat News

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Christmas and New Year – The Price of Overindulgence!

Parents are happy that the Christmas concerts are over.

Students are happy that schools are closed for holidays.

Businesses are happy that there will be a last minute rush to buy Christmas presents.

Mothers and may be some dads will be busy (and perhaps happy) doing their last minute baking and cooking.

Although there will be no peace on earth, there will be joy and happiness in many homes.

On the other hand, there are some families who find this time of the year very stressful and difficult.

Some families cannot afford the extravaganza of the Christmas festivities – the tradition of exchanging gifts, lavish feasting and partying.

Some cannot partake in the Christmas celebrations because they are sick, they are in pain, or are on the verge of dieing.

There are some who are lonely and sad because they have lost their loved ones since last Christmas.

But one thing good about our society is that there are so many voluntary organizations that take care of people for whom life has been unfair or difficult.

The generosity of the people who contribute to these organizations in cash and kind speaks volumes to our humanistic society. A society where so many are willing to give rather than complain about not having enough.

Just before Christmas almost everything in the city grinds down to a slow pace.

The hospital will be empty accept for the very sick. Most doctors (except those who are on-call) will get some time to spend with their families.

But the Christmas lull is be broken by the arrival of Boxing Day.

Emergency department gets busy – thanks to too much food and alcohol.

There will be patients with tummy ache, diarrhea, and vomiting – probably due to food poisoning. Some will have bowel blockage, some will have stomach and intestinal bleeding, some will have gall stone attacks, and some will have pancreatitis (due to gall stones or alcohol abuse).

Some will come with chest pain and heart attack. Some will be in heart failure. Some may get asthmatic attacks, some may get migraine.

Some will get involved in motor vehicle accidents, and some will get involved in fights.

Those who survive all this will soon recover to get ready for the New Year’s Eve bash. There will be more food and more alcohol. And then there will be a hangover and 2003 will be history!

The New Year will arrive with mail box full of bills instead of Christmas cards. And businesses will tempt you to buy more when everything goes on sale.

Isn’t this all wonderful? We go through the same cycle every year! And although people complain about it, there is no way anybody can change it. It is part of our life – just like day and night.

Am I being cynical about Christmas and New Year’s celebrations?

May be so. But as a physician I feel I should warn you (not that you didn’t already know about it) that there is a price to pay for over indulgence – especially when it comes to shopping, eating and drinking alcohol.

Believe me, I have seen it all.

Before I slowed down in my practice, for almost 10 years, during the Christmas week, I had volunteered to be the general surgeon on-call at Medicine Hat Regional Hospital (the old Medicine Hat General Hospital). It used to be a very busy round the clock seven days. What I write here is what I have seen.

So, enjoy the Christmas and the New Year’s Eve bash – but do it in moderation. Know your limit and you won’t regret it.

Merry Christmas and Happy New Year! Don’t drink and drive. This column will be back in January, 2004- hopefully without a hangover!

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Religion and Health

Somehow, every December, I start thinking about religion and its role in our life.

As a physician, I am always looking for ways to inform my patients that certain type of life style is good for them. But I never talk about religion. I believe it is a personal and private matter. But I have written on this subject in the past. These columns can be read on my website – nbharwani.com.

What is interesting is that a Newsweek poll shows 72 percent of Americans would welcome a conversation with their physician about faith. The same number say they believe that praying to God can cure someone, even if science says the person doesn’t stand a chance.

My question is: Do we need religion to stay healthy and happy? Does religion make us a good person?

Let us look at the second question first. Peter Alliss, TV commentator, author and golfer says in a Golf Digest interview:

“I am a humanist. I am not an agnostic or an atheist, really, though I don’t believe there is a higher power in the form of an old man with a white beard, controlling events from the heavens. I believe you go through life learning by observing good and bad in other people, and putting those lessons into practice. I believe you do unto others as you would have them do unto you, and it doesn’t take a Bible to convince me of that.”

Alliss is not the only one who believes that being religious is not always synonymous with being a good person. One can be a good spiritual person without being a religious person.

Although religion is a strong positive factor for many people, others find that it puts constraint on their freedom to be a broad minded good individual. Then there are those who use religion in a very negative way. Perhaps more than anything negative application of religion gives it a bad name.

For most people religion is a very personal and private thing. We cannot impose our beliefs on others. If people want to change then they have to search for the truth and pursue it. That desire has to come from within. It cannot be imposed from outside.

As we renew our resolutions for the New Year, our desire to change ourselves has to come from within us. Most of us have a desire to be a better, kinder, gentler person who can make a difference in the world we live. Whether religion can help fulfill our desire to be a good person depends on one’s belief and how it is applied in life.

Does religion make us healthy and happy? Should religion be part of our health care system?

The Newsweek poll says that 84 percent of Americans think that praying for the sick improves their chances of recovery; 28 percent think religion and medicine should be separate.

What does science say?

Again there are differing opinions. The difficulty is – how do you measure the power of prayer? It would be impossible to do a double blind prospective trial on the power of prayer.

The Newsweek article says that Dr. Lynda H. Powell, an epidemiologist at Rush University Medical Center in Chicago, reviewed about 150 papers on this subject. Her findings? While faith provides comfort in times of illness, it does not significantly slow cancer growth or improve recovery from acute illness.

There was one positive finding. People who regularly attend church have a 25 percent reduction in mortality. They live longer than people who are not church goers.

The Newsweek poll also shows that 84 percent of Americans said praying for others can have a positive effect on their recovery, and 74 percent said that would be true even if they didn’t know the patient. But this is not confirmed by scientific studies.

But whatever science says, every individual has his or her spiritual relationship with God. How we use that relationship to stay healthy depends on us. If we believe in something then it usually works.

I feel December is good time of the year to reflect on such matters. And remember, do unto others as you would have them do unto you! It does not matter whether you are agnostic, atheist or religious.

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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Diarrhea

Diarrhea is a worldwide problem. It causes significant ill health and many people die. The situation is worse in poor countries. Even in developed countries diarrhea causes significant illness and death.

Diarrheal diseases have been a scourge to humanity throughout recorded history all over the world. “Infections are estimated to account for three to four billion cases of diarrhea each year, and up to 4.3 million deaths in children under the age of five years,” says an article in the Canadian Journal of Gastroenterology.

Diarrhea means loose, watery stools and abdominal cramps. Frequency of bowel movements may vary in each case.

Management of diarrhea depends on whether it is acute or chronic.

Acute diarrhea is unpleasant and almost everyone experiences at one time or another. The loose stools usually last a few days.

Most common causes of acute diarrhea are due to infections:

-Viruses: Rotavirus and adenovirus are common examples in young children. Direct contact easily spreads viral diarrhea.

-Bacteria and parasites: Parasites such as Giardia and cryptosporidium can cause diarrhea. Certain bacteria like campylobacter, salmonella, shigella and E. coli can cause diarrhea. The source of infection is contaminated food or water.

-Diarrhea can also be side effect of many medications, particularly antibiotics.

-Traveler’s diarrhea can occur in 20 to 50 percent of travelers to tropical countries. Eighty percent of traveler’s diarrhea is due to bacterial infection.

Chronic diarrhea lasts much longer than acute diarrhea. Diarrhea lasting four weeks would probably be considered chronic but six to eight weeks would provide a better distinction.

The prevalence of chronic diarrhea in the United States seems to be approximately five percent.

It can be a sign of a serious disorder like chronic infection, inflammatory bowel disease or poor absorption of nutrients (malabsorption). It may be due to a less serious condition such as irritable bowel syndrome.

Other causes of diarrhea are: Lactose, a sugar found in milk and milk products, artificial sweeteners, sorbitol and mannitol, found in chewing gum and other sugar-free products can cause diarrhea.

There are many more causes of chronic diarrhea. They cannot all be mentioned here. To name few more: dumping syndrome, celiac disease, chronic pancreatitis, antacids, alcohol use and diabetes.

In one study, 30 percent of the patients a definite cause of diarrhea was found. In 20 percent of the patients the cause was found to be in laxative and diuretic abuse. In 50 percent of the patients – no specific diagnoses was made. They were given the diagnoses of “functional” or “idiopathic” diarrhea.

Most significant complication of diarrhea is dehydration – as suggested by excessive thirst, dry mouth, little or no urination, severe weakness, dizziness or lightheadedness. This can be dangerous especially in children and the elderly. One should seek immediate medical help.

Viral diarrhea can be prevented by washing hands and encouraging your children to wash their hands. One must also guard against diarrhea caused by contaminated food and water.

Several precautions should be undertaken when one is traveling in tropical countries.

Investigation of diarrhea includes history and physical examination. Blood and stool tests. If no cause is found then examination of the colon, stomach and duodenum with an endoscope should be undertaken.

Sometimes diarrhea is only an inconvenience. Sometimes it can be life threatening. Sometimes it can be prevented by good preventive measures like washing hands and avoiding potentially contaminated food and water. Sometimes there is not much you can do to avoid it – especially in cases like ulcerative colitis, Crohn’s disease and other medical conditions.

So, if you have diarrhea then see your doctor before it runs you down!

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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Influenza in Children

On November 21st, Dr. Paul Schnee, Medical Officer of Health for Palliser Health Region (PHR) sent a memo to Palliser Physicians and Staff on the subject of influenza. In the memo he indicates that five children have died in UK from influenza due to A/Fujian virus.

Dr. Schnee says, “As seen during previous influenza seasons, young children are the first to be affected. That is because most young children have little or no history of exposure to influenza viruses and have limited protective immunity.”

An article in the Canadian Medical Association Journal (CMAJ) says, “Each year, about 9-20 percent of healthy children aged less than five years will require health care for an influenza-related illness.”

So how can we protect our children from the scourge of influenza?

Current Canadian guidelines encourage vaccinating healthy young children but do not designate them as being at high risk of infection. In US, the current recommendation is that all healthy children aged six to 23 months should be given influenza immunization. This change came about recently. Can Canada do the same thing?

Children with influenza present with fever, with acute respiratory tract illness and with middle ear infection. Children under two years of age are very prone to complications like pneumonia and croup.

“The key to controlling influenza infection is prevention,” says the CMAJ article.

So how can we do that?

On November 18th, Dr. Schnee had sent a memo to Physicians and Staff of PHR titled, “Influenza information provided to the media”.

The memo contains a list of dos and don’ts which the general public should be aware of. It is well written. It is simple and easy to understand. I think it should be read by everybody.

If the PHR can afford it then a laminated copy of this memo (November 18th) should be delivered to every home in the region. It will be a good investment in preventive health. And the public will know how to make the best use of health care resources during the flu season.

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