Nicotine is Poison

• Fact: Smoking is injurious to health.
• Fact: Cancer and smoking are highly correlated.
• Fact: Cigarette smoke contains thousands of toxins, 69 of them proven carcinogens.

This blogpost  tells you more about the dangers of tobacco. It is an established fact that smoking causes damage to every organ in the body. In spite of the overwhelming evidence, most smokers find it extremely difficult to quit. This is the reality.

E-Cigarettes, a Risky Alternative

For those who cannot kick the habit, electronic cigarettes are being promoted as an alternative to smoking. Don't fall for the hype. It could be a case of the remedy being worse than the disease.

What is an e-cigarette, anyway?  They look like metallic cigarettes, but are  actually battery-operated vaporizers. Its mechanism heats up a liquid; the liquid turns into vapor, which is then inhaled, or "vaped". The liquid is typically a combination of nicotine, flavorings, a solvent and other additives.

E-cigs are tobacco-free and smoke-free, but are filled with liquid nicotine - a dangerous substance; not only when you inhale, but also by ingestion or contact with your skin. Apparently, tobacco kills slowly, whereas liqud nicotine can be lethal even in small doses: less than one tablespoon is enough to kill an adult; as little as a teaspoon could kill a child. Equally worrying is the fact that among all of the alternative tobacco products, e-cigarettes are the least regulated. You can never be sure what vapours you are inhaling.

Click here for an eye-opener published in the Guardian. Be warned - nicotine is poison, no matter how it is packaged or delivered. Still in doubt? Click here to know 10 important facts about e-cigarettes.

World No Tobacco Day

The ultimate goal of  World No Tobacco Day  (May 31) is to  protect present and future generations from the devastating health consequences due to tobacco.  The social, environmental and economic scourges of tobacco use and exposure to tobacco smoke are so terrible that every day ought to be No Tobacco Day.

Each year, the global tobacco epidemic kills 6 million people. At least 600 000 of these are non-smokers dying from breathing second-hand smoke. Unless we act, the epidemic will kill more than 8 million people every year by 2030. More than 80% of deaths will be among people living in low-and middle-income countries like India. Tragically, these are preventable deaths - which means that with adequate preventive measures -such as awareness, ban on ads, sales, higher taxes and smoking in public places - these people need not suffer and die.

To know more about the  deadly effects of tobacco, check out  Cancer Sticks and WHO Facts.

The Obstacles

There are two extremely powerful forces which stand in the way of eliminating the use of tobacco.The first is money - tobacco is a multi-billion dollar industry. Historically, the tobacco industry has employed a multitude of tactics to shape and influence tobacco control policy.

They use their huge economic power, lobbying and marketing machinery, and manipulation of the media to discredit scientific research and influence governments in order to propagate the sale and distribution of their deadly products. The second obstacle is the addictive nature of tobacco and you - once you're hooked, you're hooked!

Win-Win Strategy

For World No Tobacco Day 2014, WHO and partners call on countries to raise taxes on tobacco. Increasing excise taxes on tobacco is considered to be the most cost-effective tobacco control measure. This week, the Government of India have announced that  fresh excise tax measures will  be  implemented (Currently, India's annual excise revenue from tobacco products is Rs120 billion). Because it will also raise government tax revenues which can be allocated to more public health care, it is a win-win strategy all the way.

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Cancer Sticks

Why does a sane person knowingly poison his lungs? Here we're not talking of suicidal individuals, driven to take extreme steps to end it all. These are normal people who keep smoking, choosing to ignore known dangers.

Smokers cause damage to their own bodies and to all those who are near them. Indirect smoking is as bad, if not worse. Passive smokers are hapless victims - trapped in homes, offices, restaurants, trains - when someone lights up the cancer stick.

Proven Risks

Unfortunately the risks are real. Tobacco smoke affects our bodies from head to toe. You may be surprised at some of the ways smoking has a negative impact on our health.

Smoking is hard on the heart and lungs. but the fact is, tobacco use plays a role in a multitude of diseases that ultimately lead to disability and/or death. Cigarette smoke contains over 4,000 chemical compounds; 200 of which are known to be poisonous and upwards of 60 have been identified as carcinogens. It's no wonder that the effects of smoking are so widespread and destructive. 

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Disease in Bold are  Most Likely to Affect a Smoker

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Denial will not make the problem go away. And yet, motivation and capacity to kick the habit are alarmingly low. The fact of the matter is that you better not  start smoking. Once you're hooked,  tobacco is addictive. Precisely because it is hard to break the habit, one finds lame justifications.

• What problem? There is no problem.
• I'm used to it ... my body is strong. 
• My father/uncle/friend smoked all his life and lived to a ripe old age. I'll be fine.
• The danger is exaggerated.
• Why worry now? I have many other things on my mind.
• May be a small risk, but not a big deal
• I'll take my chances; everybody has to die, anyway.
• I don't smoke too much... just a few / only a pack a day.
• I can't concentrate/function/de-stress unless I smoke.
• ok, ok! I know I should do something ... I'll think about it.
• I'll try to cut down ... maybe tomorrow / next month / next year.

Which of these rationalisatons have you not heard? Quitting  is difficult. But not impossible. Similar to the AA method, the first step is to admit to oneself that there is a serious problem. The next is to get information and help.  See these links from the USA,  UK and India. I also came across this Facebook Page.

Disturbing Trends

Worldwide, 661 million people smoke, while 247 million use smokeless tobacco products.The situation is particularly acute in developing nations, where roughly half of adult men use tobacco. 275 million Indian adults are tobacco users. 75% of them consume smokeless tobacco products. More and more Indian women - said to be the highest in the world - chew "gutka", "khaini" and "zarda".

Their Gain is Our Loss

People in developed countries increasingly understand the dangers of smoking. Their governments continue to implement tobacco control policy and legislation. Therefore, the sale of cigarettes in the West has significantly gone down. To compensate for their shrinking markets in Europe and America,  tobacco-based companies have shifted the full force of their marketing to India and other developing countries. They are succeeding! Cigarette consumption is increasing in low and middle-income countries,  high enough to offset the decrease in Western countries. Read more here and here.

Why?

The sale of tobacco products is steadily rising in India, primarily because of targetted marketing and ineffectual government legislation. Due to low awareness of the harmful consequences, there is social acceptability and often a badge of maturity! With economic prosperity and population growth, consumption is expected to increase even more. Overall, a highly disturbing trend, with grave repercussions on the health of our young men and women as well as the next generation.

Dancing Gorilla

Have you ever wondered how x-rays and scans reveal the condition of your lungs or brain or some other part of your body? Evidently, those mysterious black and white images make sense to radiologists. Because they know what a normal or healthy person's scan looks like; and their eyes are trained to detect abnormalities at a glance.

This is the CT scan of a patient's lung. Look closely at  the top of the right lung. Do you see anything unusual?

Don't worry if you did not spot the dancing gorilla. In a psychological experiment, several expert radiologists were shown this scan and asked to look for indications of lung cancer. A whopping 75 per cent failed to notice the gorilla!

Does the experiment suggest that medical specialists are not good at detecting signs of potentially life-threatening conditions by looking at CT scans? Not at all. This happens because they are proficient at detecting abnormal signs. When the radiologist looks at a scan with a specific focus - in this case, to spot nodules that indicate cancer in the lung - he automatically filters out other things that might distract him. Including dancing gorillas :)

This is simply how our attention system works. Not just with radiologists, but with everyone. It is called inattentional blindness. Scientists say that there is a big difference between looking and perceiving. Read more about it Here.

Dirty Hands

Did you know that hands are one of the *dirtiest* parts of the body?  Why, because our hands touch many things that are not clean. Not only when we use the bathroom, but other surfaces too. So which are the top suspects?

Keyboards: I was taken aback to read that the computer keyboard - which my fingers are tapping right now - probably carries much more bacteria than a toilet seat. Honestly,
I can't even remember when I last cleaned my keyboard!

Handles: Light switches, doorknobs and handles - these are some of the objects that everybody touches every day. If they are in public places, who knows what germs are being transmitted when you touch them? 

Menu Cards: You enter a nice clean restaurant, use the washroom to clean your hands, sit at a table and pick up a menu card. Wait a second! How many people must have handled that card - coughed, sneezed, touched with dirty fingers? Do restaurants clean their menu cards?

Cash: It circulates rapidly from hand to hand. It is never washed! Go figure...

Cellphones: It goes in pockets and bags; sits on all sorts of surfaces - chairs, tables, beds. You don't always pick it up with clean hands. Your spit falls on it as you talk. Do people disinfect their cellphones regularly?

This is just a partial list. There are others - your kitchen sponge, pillow cover and more...

Wash your hands!

How often should you  wash your hands? The oftener the better!  Wash after using the bathroom. Wash after  you enter your home or workplace. Wash before eating with your fingers.

Good hand hygiene is essential to prevent avoidable infections. Holding your hands under the tap for a few seconds is not good enough. Click here to learn How to Wash Hands.

Autism

The birth of a baby is a joyous event. Three months ago, my daughter gave birth. Just a few days ago, my daughter-in-law did the same. Now I have two new, healthy, angelic grandchildren. Watching, admiring and nurturing the little ones is a joy that has no comparison.

Autism
As a baby grows, each day brings new signs of growth and development. But if the child has autism, within the first two years parents notice unusual behaviour that tells them that something is wrong.

Autism or ASD is a pervasive neural developmental disorder. It is diagnosed by certain characteristic symptoms such as impairments in social interaction, communication and repetitive behavior. It is shattering for the parents when they are told that the causes are unclear and there is no 'cure'. It is the beginning of a frustrating and stressful journey for the child and the family. More often than not, as the condition deteriorates, the road spirals downwards.

I have only an outsider's view of what it means. Harshita Mahajan, the mother of an autistic child, gives us a glimpse into her world. Every day she learns something new about herself and her autistic son.

A Mother's Words

I am the mother of 14-year-old Sahil, a boy on the autism spectrum. I have been reading, living and breathing autism for the last 12-and-a-half years. Being faced with autism 24/7 brings out the best and worst in me. We have had highs and lows and many, many plateaus. I have learned slowly who my son is… and learned to appreciate his character, intellect and love for me.

I have learned to count my blessings: The fact that despite being severely impaired in many aspects of his life, his cognition is relatively intact; in spite of the physiological challenges and many invisible medical issues my son grapples with, he has a wonderful positivity and even more amazing implicit trust and faith that I will finally make things better for him; the fact that my son has learned to use the written medium to communicate his deepest feelings and thoughts; that from somewhere, I am usually able to dig very deep within myself and find the strength to continue to NOT accept his impairments as carved in stone and look for solutions with the same intensity as I did 12-and-a-half years ago.

But sometimes this sanctum Sahil and I exist in, is violated. Yesterday, we were going on a family visit to the aquarium. He had worn his shoes and jacket and was waiting impatiently for me at the door of our apartment. I was locking up and then remembered that I had forgotten my camera inside. I re-entered my apartment to retrieve it and in the meantime Sahil made off to the lift. By the time I reached the lift lobby, he had already gotten into a lift and disappeared. This has happened before, and normally he always comes straight back to the sixth floor where we live.

I pressed the lift button, waited patiently for a lift door to open on our floor. A lift arrived and the door opened…the lift was empty. I let the door close and pressed the lift button again to call the second lift…convinced he would be in it. The lift door opened and my neighbour emerged. He said, “Hi, your son is in the lobby, taking down the Christmas tree.”

All you need to destroy a balloon is a pinprick… this was my pinprick.

When I reached the lobby, sure enough Sahil had denuded the apartment Christmas tree of all the ribbons decorating it. I grabbed the ribbons, mortified and placed them on the table. I forgot about all the intelligent things he had ever typed, the fact that his school principal thought that one day he might go to college…

All I can think is what a friend of mine had said to me once… that autism is a zero sum game… you are either functional or you aren’t. Cognition doesn’t make the cut alone… it’s only a small part of the puzzle… a contributor to functionality… perhaps important but there are so many other important skills that make human beings functional enough to live in a society… social understanding… impulse control… emotional balance… and many, many other prerequisites.

And why did he pull the ribbons off the tree instead of coming back to the sixth floor? Perhaps because he is obsessed with stringy objects and because of his irritation at being made to wait, and the fact that he knew he was unsupervised, he succumbed to the urge to get at the ribbons.

I had argued with my friend that in terms of her binary analogy that autism was a journey where we moved from the zero to the one. But finally you have to decide whether you are at zero or at one.

Senior Moments

The Twilight Years

You, me and everybody else who are fortunate enough to live long, will see their hair turn grey or disappear. The inescapable process of aging will intrude into your life, whether you are prepared for it or not.

The problems of growing old are well known. There is plenty to read, see, discuss and do regarding them. In fact, we have a special healthcare subject dedicated to it - geriatrics. This short video clip is a whimsical look at some pinpricks that senior citizens face.  The language is Hindi, but the visuals alone should suffice. Listen with your inner ear as you enjoy the unforgettable Mohammed Rafi in the background.

The End of the Road

Some day - nobody knows when - I will die.

I wish I could say this to myself every single morning when I wake up. Then, perhaps I would live my days differently!

What do people regret the most  when life is ebbing away? Bonnie Ware is an Australian nurse who, for many years, cared for people in their last days. She has recorded their most common regrets in her blog  Regrets of the Dying. You might be surprised at the top five on the list. What would you put on yours?

Let's  look at the bright side too. On your life's page, put down the highlights that gave you joy. In each of your sentences, fill in the blanks: I'm glad_________________ happened in my life.

I tried it and found myself feeling good and counting my blessings :)

Breast Cancer - Are You at Risk?

Breast cancer cases are surging across the globe. Over the past three decades, worldwide, the number of new breast cancer cases diagnosed  increased dramatically -  6 lakhs in 1980 to 16 lakhs in 2010. It is the Number One  cancer among Indian women living in cities. In a lifetime, one in fifteen women in India is diagnosed with breast cancer.

What causes cancer in the breast? The result of empirical research points at genetic predisposition, lifestyle, hormonal changes. In other words, the answer is not definitive.

What can a woman do to prevent its occurrence? Apart from adopting a normal, healthy lifestyle,  precious little. However, early detection is the most significant factor affecting survival. I was extremely fortunate to get an early diagnosis and prompt treatment. This was many years ago. Nowadays, medical science has made much progress. Diagnosis, treatment and survival rates are better.

Do you have breast cancer?
Every woman above 40 years must keep her eyes peeled for the early warning signs. Do a breast self-examination(BSE) once a month, in the privacy of your bathroom.

Look for a painless lump in the breast or the armpit, changes in the shape, colour or texture of the breast or oozing from the nipple.  Even if you have none of these symptoms, an annual medical check-up which includes breast cancer screening (mammogram) is a must. 

Believe me, ladies, breast cancer cells in your body  are far, far more dangerous than insects in your kitchen. If there are any malignant cells lurking in your body, do all you can, as quick as you can, to find and destroy them!

Want to know more?
Diagnosing Breast Cancer
Girl Stuff
Y-Me Answers
Info from Mayo Clinic
Another Cancer-related Site

Prashant

Peace of Mind ... A story from Buddha’s life

Once Buddha was walking from one town to another with his followers. They halted when they happened to pass by a lake. Buddha told one of his disciples, “I am thirsty. Please get me some water from that lake.”

The disciple walked up to the lake. When he reached it, he saw some people washing clothes in the water. Right then, a bullock cart started crossing through the lake. As a result, the water was muddy and turbid. The disciple thought, “How can I give this dirty water to Buddha !” So he came back and told Buddha, “The water is very muddy. It is unfit to drink.”

After some time, again Buddha asked the disciple to go to the lake for some water to drink. The disciple obediently went back to the lake. This time he found no disturbance -the lake was still and peaceful. The mud had settled down and the water above was absolutely clear. So he filled the pot and brought it to Buddha. Buddha looked at the water, and then at the disciple. He said, “See what you did to make the water clean - you just let it be! The mud settled down on its own and you got clear water. Your mind is also like that lake. When it is disturbed, just let it be. Give it some time. It will settle down on its own. You don’t have to put in any effort to calm it down. It will happen. It is effortless.”

Reflection
Buddha said, “It is effortless” meaning that *Peace of Mind* is not a strenuous job; it is a steadying process. If you attain peace and tranquility, you are Prashant.

When there is peace inside you, that peace permeates outside. It spreads and surrounds you like an aura, so that people around start feeling the same peaceful vibes.

Om Shanti !

Breast Cancer

It can happen to any woman, at any age. I've known women who had breast cancer in their teens and even in the nineties. A question that often comes up is - How shall I check whether I have suspicious symptoms?

Symptoms
In its early stages, breast cancer usually has no visible symptoms. As the tumor develops, one or more symptoms become apparent. Here's a checklist of eight warning signs.

1. A lump in the breast or underarm. Often the first symptom noticed. These lumps are painless, but will not disappear. Lumps are usually visible on a mammogram long before they can be seen or felt.
2. Swelling: Usually in the armpit. Sometimes in the neck.
3. Pricking pain or tenderness in the breast can be a sign of cancer.  
4. Flattening or indentation on the breast. 
5. Change in the size, shape or 'feel' of the breast. A reddish skin like an orange.
6. Nipple: indrawn or dimpled look, itching or burning sensation, ulceration or scaling.
7. Discharge from the nipple, which is clear, bloody or another color. (It is not always due to cancer)  
8. An area that is different from any other area on either breast. eg: a marble-like area under the skin. 

Medical Check-up

If any of the above eight signs persist, a medical check-up is strongly recommended. The standard medical diagnostics for breast cancer are

• Physical examination by a qualified doctor (oncologist)
• Mammogram  and MRI (radiology tests)
• FNAC  (a needle inserted to take a sample for lab tests)
• Biopsy (another method to take a sample for lab tests)

Which investigations are advised by the oncologist depends on the individual case.

Remember: Early detection and prompt treatment are the keys to recovery.

Some questions that a woman might ask: Am I at risk? Can I protect myself? What is the treatment for breast cancer? What are the chances of recovery? Is there life after cancer? To find answers, please click here.

Swine Flu

It is mid-August and schools in Bombay, Pune and Bangalore and some other cities have shut down to avoid the spread of swine flu. People are wearing protective masks in public places. Many are staying home and wondering whether to stock N95 or Tamiflu. Will it turn into an epidemic in India? Are you in danger?

My friend Anita D sent me the following easy-to-follow note (I've tweaked it a bit.) Useful indeed !

Preventing Infection

Face masks and N95 respirators are for general protection against H1N. Most N95 respirators are designed to filter 95% particulates of 0.3µ, while the size of H1N1 virus is about 0.1µ. So dependence on N95 to protect against H1N1 is like protecting against rain with an umbrella made of mosquito net. Tamiflu does not kill the infection, but prevents H1N1 from further proliferation till the virus limits itself in about 1-2 weeks (its natural cycle). H1N1, like other Influenza A viruses, only infects the upper respiratory tract and proliferates there. The only portals of entry are the nostrils and mouth/ throat. Avoid Contact - Contact with H1N1 is dangerous. Avoid crowds, places with poor ventilation and people who are already affected.

But in a global epidemic of this nature, it's almost impossible not coming into contact with H1N1 at all. Then we have the problem of proliferation.

Preventing Proliferation
Suppose you are still healthy and not showing any symptoms of H1N1 infection. In order to prevent proliferation, aggravation of symptoms and development of secondary infections, some very simple steps can be practiced:

1. Frequent hand-washing is very important. 2. "Hands-off-the-face" approach. Resist all temptations to touch any part of face (unless you want to eat, bathe or slap). 3. Gargle twice a day with warm salt water (use Listerine if you don't trust salt). 4. Clean your nostrils at least once every day with warm salt water. Not everybody can do Jala Neti or Sutra Neti (Yoga asanas to clean nasal cavities), but blowing the nose hard once a day and swabbing both nostrils with cotton buds dipped in warm salt water is effective. H1N1 takes some days after initial infection in the throat/ nasal cavity to proliferate and show characteristic symptoms. Simple gargling prevents proliferation. In a way, gargling with salt water has the same effect on a healthy individual that Tamiflu has on an infected one. Don't underestimate #3 & #4 above... simple, inexpensive and powerful preventive methods. 5. Boost your natural immunity with foods that are rich in Vitamin C (Amla and other citrus fruits). If you have to supplement with Vitamin C tablets, make sure that it also has Zinc to boost absorption. 6. Drink as much of warm liquids as you can. Drinking warm liquids has the same effect as gargling, but in the reverse direction. They wash off proliferating viruses from the throat into the stomach where they cannot survive, proliferate or do any harm.

All these are easy ways of prevention, well within the means of your household. They are certainly much better than waiting in long queues outside public hospitals.

Happy breathing!

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