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Preventable Diseases

I call them the diseases of mass destruction!

What are they?

They are preventable conditions that are killing millions of people prematurely.

Why?

Because too many of us are living dangerously. Around the world, 56 million people die each year. About 40 per cent of these deaths are due to top 10 preventable conditions. These conditions have been identified by the World Health Organization (WHO) in its report released last year. Here is the list:

1. Childhood and maternal underweight rates
2. Unsafe sex
3. High blood pressure
4. Tobacco use
5. Alcohol use
6. Unsafe water, sanitation and hygiene
7. High cholesterol levels
8. Indoor smoke from solid fuels
9. Iron deficiency
10. Obesity

The World Health Report 2002 represents one of the largest research projects ever undertaken by the World Health Organization. In collaborating with experts worldwide, WHO has collected and analyzed evidence that will have implications for global health for many years to come, says the report.

What is the goal of the report?

The ultimate goal is to help governments of all countries to raise the healthy life expectancy of their populations – from the poorest to the richest. Everybody stand to gain another five years or so of healthy life, says the report.

Here are some other important points from the WHO report:
-Health problems of developing countries are worse. For example, at least 30 per cent of all disease burden occurring in many developing countries, such as those in sub-Saharan Africa and South-East Asia, results from fewer than five of the ten risks listed above.
-Underweight alone accounts for over three million childhood deaths a year in developing countries.
-In the most industrialized countries of North America, Europe and the Asian Pacific, at least one-third of all disease burden is caused by tobacco, alcohol, blood pressure, cholesterol and obesity.
-More than three-quarters of cardiovascular disease — the world’s leading cause of death — results from tobacco use, high blood pressure or cholesterol, or their combination.
-High cholesterol causes more than 4 million premature deaths a year.
-Tobacco use causes almost 5 million premature deaths a year.
-High blood pressure causes 7 million premature deaths a year.

If preventive measures are undertaken to combat these diseases of mass destruction then the life expectancy can be increased on average about five years in developed countries and 10 years in developing countries.

In Canada, healthy life expectancy could increase by 6.5 years, from their current 69.9 years to 76.4.

The WHO report says that the cost of inaction is serious. If nothing is done, then most of the premature deaths will probably double by the year 2020.

Inaction should not be on our agenda this year.

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What are we really like?

Do we really have to make New Year’s Resolutions?

Studies have shown that people understand their health risks but do not necessarily change their lifestyle. Then why make resolutions and then suffer from sense of guilt?

Surveys have shown that 57 per cent of people are not motivated to stay healthy. Thirty four per cent of people have no time and 30 per cent have financial barriers to pursue a healthy life style.

What I really like to do today is to share with you an interesting column I read recently.

“What are we really like” is the title of a column written by Murray Campbell in a recent issue of The Globe and Mail. By looking at surveys done by different Canadian pollsters, he came up with one hundred items that reflect “what the nation’s prevailing neuroses are in a given year”.

From his list I have picked few health related items. See which item applies to you and whether you need to do something about it in 2003.

-8 per cent of Canadians report at least one major episode of depression in the past year

-15 per cent of Canadian men and 20 per cent of women say they have been under so much stress that they contemplated suicide

-20 per cent of children live up to Canada’s Food Guide and consume at least five portions of fruit and vegetables daily

-25 per cent of Manitobans smoke, the highest rate of tobacco use in Canada. Just 17 per cent of B.C. residents smoke.

-27 per cent of Canadians say they shun prescription and non-prescription drugs

-28 per cent of smokers say there should be a law preventing parents from lighting up at home if children are present

-34 per cent of Canadians take work home with them

-40 per cent of Canadian Forces members consider themselves fat

-48 per cent of children seven to 12 years old eat junk food for an afternoon snack

-50 per cent of Canadians are overweight or obese and 70 per cent of them are satisfied with their weight

-52 per cent of Canadians take vitamin supplements regularly but only 17 per cent say they eat the recommended daily servings from Canadian Food Guide

-59 per cent of adults say that gardening is their prime leisure activity.

-66 per cent believe family is more important than work

-71 per cent of British Columbians have signed an organ donation consent form, compared with 48 per cent in Manitoba and Saskatchewan

-73 per cent of Canadians are satisfied with their household income and 82 per cent are happy with their job

-75 per cent of Canadians work more than 40 hours a week with one in four clocking 50 hours

-83 per cent of drivers make sure their passengers are wearing their seat belts

-86 per cent of parents, guardians and other caregivers say they are overwhelmed by the amount of information on children’s health that is available; 46 per cent find the information is inconsistent, conflicting or out of date

-88 per cent of Canadians say there is no need to raise taxes to improve the medical-care system

-91 per cent of Canadians over the age of 40 say they are sexually satisfied, but only 73 per cent reported having sex in the past 12 months

-93 per cent of Canadians know that car exhaust affects air quality, but only two per cent are prepared to use their own vehicle less

-96 per cent of parents think their children are happy and well balanced

-97 per cent Canadians say they suffer from intestinal gas and about 15 per cent say they have cancelled a date or a meeting because of it

What puzzles me is why 91 per cent of Canadians over the age of 40 say they are sexually satisfied, but only 73 per cent reported having sex in the past 12 months – what about the rest of them? Do they suffer from intestinal gas? Or are they more interested in gardening?

Have a happy healthy new year – who cares whether it is with or without intestinal gas – Eddie Murphy never worried about it in The Nutty Professor!

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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Religion and Peace

My first column appeared on August 13th, 1998. In that my imaginary friend Dave asks, “Doc, how can I stay healthy?”

This question is valid today as it was four years ago. Perhaps it has been valid for many hundred years. I guess our ancestors cared about their health as much as we do. And our struggle to stay healthy will continue. There are no short cuts and no magic pills. Its hard work!

Some people believe that physical health should go hand in hand with spiritual health. But is our spiritual health in any better shape than our physical health?

My December 30th, 1999 column was about “nirvana for the lifetime”! As somebody has said, “If a man thinks about his physical or moral state, he usually discovers that he is ill.” If we look at the philosophy and practices of all the great religions of the world we would not find any people in the world who do not believe in the existence and survival of human souls.

Unfortunately, we have people in our society who do not believe in this.

More than half the world’s population is made of Christians and Moslems. Like the Bible, the Qur’an is a book of divine revelation. The Bible and the Qur’an both reveal the word of God, says an article in The Newsweek. Both speak of prophets, redemption, heaven and hell.

Judaism, Hinduism and Buddhism make up most of the rest of the world who believe in God and the triumph of good over evil.

Historically, people have been fighting with each other since Adam and Eve. All the messengers of God have come and gone. They made many changes. But they did not abolish greed, conflicts, wars, hatred, revenge and thirst for blood.

Religion and education has made us smarter but we cannot get rid of our primitive instinct of hatred and revenge. Well meaning decent people try very hard to suppress those unhealthy feelings. And to most extent they succeed. But there are others who use their religion and education to produce more powerful and sophisticated weapons of mass destruction.

Nobody talks about the gentler kinder society anymore. Not even in the month of December. We are still talking about war, suicide bombings and revenge. All the talk is about attack. Is there a safe place in this world to hide, relax and meditate?

I was looking at my millennium edition column in The Medicine Hat News. It was about ELMOS (exercise, laughter, meditation, organic healthy food, stress relief). The message was and is to combine physical health with spiritual health. Exercise for the body, peace for the mind, prayers for the soul. That was two years ago!

In the last month or so, Hindus celebrated Divali, Muslims celebrated Ramadan and Eid, Jews celebrated Hanukkah, and now the Christians will celebrate Christmas. That means billions of people all over the world would have gone through prayers and celebration in one month. Is this going to change the bad and the ugly in our society?

May be it is time to clone a messenger with DNA from Jesus, Confucius, Moses, Mohamed, Krishna, Buddha, and call him – JECOMOMOKRIB. The question is – will he succeed where others have failed? Especially with a name like JECOMOMOKRIB? Sounds like Michael Jackson!

So how do you plan stay healthy in mind and body in 2003? Do you think Michael Jackson can heal the world or do we need JECOMOMOKRIB?

Greetings for the holiday season and Happy New Year. Let there be peace for all! Amen.

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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Hysterectomy

Hysterectomy means surgical removal of the uterus. It is the most frequently performed major surgical procedure in gynecology. Hysterectomy came into widespread use about hundred years ago.

Last year, in Palliser Health Region, 159 hysterectomies were done, 50 vaginal and 109 abdominal.

In Canada, in 1998-99, 462 hysterectomies were done per 100,000 women over the age of 20. This rate varies per province from a low of 434 in British Columbia to a high of 750 in Newfoundland. Within each province, the rates fluctuate significantly by region as well, says Health Canada statistics.

The rates also fluctuate among different Western countries. For example, 37 per cent of women in the United States have had hysterectomy by the age of 60, compared to 20 per cent of women in the United Kingdom.

This raises several questions:
-Why are so many hysterectomies performed?
-Why do the rates vary so much?
-What are the outcomes, and do outcomes differ among different types of hysterectomy?

Answers to these questions are discussed in the October 24th editorial in the New England Journal of Medicine (NEJM).

In 1880, death rate due to abdominal hysterectomy was 70 per cent. In 1930, it was three per cent. Now it is less than 0.1 per cent. This has made it safer to operate on women with benign and malignant gynecological conditions. Thus more women benefit from the procedure.

Most common indication for hysterectomy is to improve a woman’s quality of life rather than cure life-threatening conditions, says the NEJM editorial.

The majority (85-90 per cent) of hysterectomies are done for fibroids, endometriosis or uterine prolapse. And their symptoms are:
-Heavy or irregular uterine bleeding
-Pelvic pain
-Pelvic pressure

There are several reasons why rates of hysterectomies vary from country to country, province to province and from region to region. For example, application of drug therapy and minimally invasive surgical techniques are available to treat the conditions for which hysterectomy may be performed, says the editorial.

However, the success of such methods of treatment are not always uniform and without side-effects. Some women are desirous of keeping the uterus and others want relief from hysterectomy. And a treating physician’s preference becomes an important factor in deciding whether hysterectomy should be done or not. All these factors make rates of hysterectomy variable.

The editorial says that there is no universal agreement with respect to strict criteria for hysterectomy, and treatment is currently tailored to individual patients. Studies have shown that 96 per cent of women who had hysterectomy for severe pelvic pain had complete resolution of their symptoms.

Currently there are three ways of doing hysterectomy: vaginal, abdominal and laparoscopic. This may be total (including the cervix), or subtotal (cervix is preserved), and with or without ovaries.

In Canada, in 1999-2000, 32 per cent of hysterectomies were vaginal, the rest were abdominal and laparoscopic.

In U.S., between 1990-97, 65 per cent of hysterectomies were total abdominal, 23 per cent total vaginal, 10 per cent total laparoscopic, and two per cent subtotal abdominal or laparoscopic. The NEJM editorial says that it is not clear whether all types of hysterectomy result in similar outcomes.

However, hysterectomy, whether total or subtotal, has beneficial effects on urinary tract symptoms like stress incontinence, urgency, frequency, and voiding at night. And it does not cause deterioration in sexual function.

Over the last 100 years, hysterectomy has helped many women improve their life style. It will continue to do so until other treatments are developed that provide similar results, says the editorial.

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