Dr Shreevidya Venkatraman

This is the concluding part of  the year-long series by the author.

Travelling has become an integral part of our lives exposing us to many adversities. Hence you should always be prepared when travelling. You have to make sure you will be able to handle situations even if you’re miles from your home. Here’s one thing that you shouldn’t leave without – a travel medicine kit. Who knows what may happen while travelling? Having a kit handy will save you from minor embarrassments like  indigestion or even life threatening situations. Here are some medicines that you may want to consider packing while going on a trip.

• Medicines  to treat indigestion or gas problems (Ranitidine/chewable antacid tablets)
• Antibiotic tablets just in case you go somewhere remote (with proper  prescription)
• Antidiarrhoeal medication
• Antihistamines for insect bites  and allergies
• Antiseptics or antibiotic creams for wounds and scratches
• Aspirin or Ibuprofen for minor pains like headaches and muscle pains
• Baby powder to soothe prickly heat
• Bandages, gauzes, micropore tape for dressing wounds
• Decongestant
• Elastic bandages for sprain and strains
• Insect repellant sprays or lotion
• Motion sickness tablets
• Thermometer
• Swiss army knife
• Other prescription medicines that you need How to Pack the Medicine Kit
• Use a waterproof pack.
• Use plastic pill cases instead of  glass  ones.
• Pack medicines in individual plastic covers or ziplock cases.
• Since these medication usually get stored and rarely used, make sure you keep track of expiry dates.

It may appear as if you are packing everything but being prepared is always best.

How to pack a first-aid kit

Anything can happen these days. If you happen to live where such occurrences are quite common, you just have to be prepared for them. One thing you can do to help survive disasters is to stock up on emergency supplies.

The rule of thumb is to have at least supplies to last you four days. It’s a must to have a first-aid kit at each home to be prepared for any accidents. Also be sure to pack a first-aid kit and bring it with you (or place it in the car) in case of any emer

gencies. Prepared kits are available, but just in case you want your own customised medical kit, here’s a guide for packing one for you.

What to include:

• First-aid manuals
• Large triangular bandages
• Individually-packed gauze pads
• Rolls of 2” and 4” gauze bandages
• Butterfly bandages
• Roll of 1” micropore tape
• Cotton balls
• Cotton swabs
• Sterile scissors (can be boiled in water for 10 minutes after being washed)
• Sterile tweezers (can be boiled in water for 10 minutes after being washed)
• Eyedropper
• A bar of plain (unscented) soap
• Hydrogen peroxide

Dr Shreevidya Venkatraman is a Consultant Physician at Apollo Clinic, Chennai. For health related queries email her at drshreevidyav@gmail.com.

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Dr Shreevidya Venkatraman

The one sided race against time is what makes people forget healthy living. They eat on the run, not giving attention to what they eat, how much they eat, where and how they eat. Fast food is tempting, cheap and filling. It’s okay once in a while but when it is something you cannot avoid on a daily basis, keep the following tips in mind:

• Watch portion size
• Always order a salad when eating at traditional outlets
• Eat small meals, that are enough to satisfy your hunger
• Make a habit to eat a fruit, or a low fat snack before you start on an errand
• Keep a stock of water and healthy snacks
• Don’t add a sugary, calorie rich drink to an already unhealthy meal Remember, regular eating can help you feel full and avoid temptation

Staying fit

Recently I read an article by a popular fitness guru which emphasised exercise as a priority and suggested finding a way to fit the gym into your everyday schedule. It made me think is this really practical for a working mother or someone who travels a lot like an insurance agent? Those who are balancing multiple roles often find that 24 hours are not enough. Fitness gets put on the back burner. You may not have time to work out but you can definitely be physically active to burn the calories you consume and boost your metabolism by using a bit of creativity in planning your day. This is what you can do:

• If there is sport enthusiast in your  family, play along. Playing cricket and  football or swimming are fun ways to  exercise. What is recommended is 30-45 minutes a day, but even 15 minutes of high activity level is enough to increase your heart rate, elevate your energy and speed your metabolism.
• Take your kids for a walk. If their speed is slow, add a few lunges, jumps or running every few minutes to make yourself work harder.
• Let children ride their bicycles while you jog along.
• Get into some vigorous sweeping, vacuuming, or mopping. These types of housework can burn a lot of calories.
• Getting off the bus a couple of stops before your destination on a regular basis adds to a lot of healthy heart  walking.
• Do yoga or floor exercises in front of the TV. At least a few sit ups or pushups during every commercial while watching a movie.
• Those in sedentary jobs, take a short but brisk walk during the lunch break.
• Practise yoga or simple stretches while talking on the phone or while cooking.
• Wake up 15-20 minutes earlier than the rest of your family and get in a few minutes of exercise into that time.

Stress busters

Effective stress control goes a long way to enhance your physical and mental wellbeing. But it is not possible to take a walk or meditate when you are facing a crisis. But you can always do a controlled breathing exercise when you feel your stress levels soaring in the following way:

• Sit upright in a comfortable position
• Focus on your present state and block all intrusive thoughts
• Breathe slowly and deeply. Breathe in through the nose and out through the mouth
• Try to make the breathing out as long as possible
• Practise this technique 15-20 times a day Relaxation techniques are very effective in dealing with panic attacks, anxiety, and stage fright. Taking a restorative pause to focus on your breathing is a valuable anger management tool.

Avoid insomnia and get a good night’s sleep Short term sleep loss or insomnia can become habitual and lead to a lot of stress. It is very important to overcome transient insomnia before trying medicines.

• Make your bedroom an inviting place. Keep it free of clutter and distractions. Be sure you have the right bed and mattresses for your needs.
• Use the bed only for sleeping. Avoid using the bed to watch TV, eat or work. If you wish to do some night time reading, read a pleasant book.
• Recondition yourself: if you are not at all sleepy, move to another room so that you associate your bedroom only with sleep and not wakefulness.
• Establish a sleep-wake cycle wherein the body’s internal clock gets used to the system. Wake up at the same time everyday even on weekends and holidays.
• Do not take long naps no matter how tempting especially in the weekends.
• Limit your consumption of coffee, tea, chocolates, cocoa and carbonated drinks in the evening.
• Excessive alcohol and smoking can also worsen insomnia.
• Fit some exercise into the day but don’t exercise strenuously before sleeping time.
• Eat light meals in the evening.
• Establish a winding down time before sleeping to free your mind of distracting and disturbing thoughts. Do some relaxing activity like reading, listening to music or watching a light movie.

Dr Shreevidya Venkatraman is a Consultant Physician at Apollo Clinic, Chennai. For health related queries email her at drshreevidyav@gmail.com.

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Dr Shreevidya Venkatraman

What is an allergy?

An allergy is an abnormal reaction of a person’s immune system to a normally harmless substance. A person without allergies would have had no reaction to this substance, but when an allergic person encounters the trigger, the body reacts by releasing chemicals which cause allergy symptoms. However, just because there is a cause and effect between exposure to a substance and the development of symptoms, it does not always mean that a person is allergic to that substance. For example, medications have known and expected side effects; a person experiencing one of these side effects is not necessarily allergic to that medication.

What happens in an allergic reaction?

During an allergic process, the substance responsible for causing the allergy or allergen binds to allergic antibodies present on allergic cells in a person’s body. These cells then release chemicals such as histamine and leukotrienes, resulting in allergic symptoms. We are exposed to many allergens like pollen, molds, animal danders, dust mites, foods, venoms and medications and our immune system gets sensitised forming antibodies against those allergens. With later exposures, that same allergen binds to its corresponding antibody on allergic cells, and the body reacts with symptoms of allergies. Allergic symptoms can vary somewhat with the type of allergen and route of exposure (airborne pollen exposure may cause different symptoms than eating a food to which you are allergic).

When and why do people develop allergies?

It is unknown why some people develop allergies and some don’t. Allergies seem to run in families, and in some cases family members can share allergies to specific foods or medications. It appears that the allergic response was once meant to protect the body against parasitic infections, although now it seems to be an abnormal response to non-infectious triggers. Allergies can occur at any time during our lives, but are more common to occur during childhood or young adulthood.

Food allergies

Food allergies can occur at any age. Almost all people with food allergies will have a skin symptom, such as hives, swelling, itching or redness of the skin, as a result of eating the culprit food. These symptoms typically occur within a few minutes of eating the food in question, although they can be delayed up to a couple of hours.

Other symptoms of food allergies can include nausea, vomitting, stomach aches, diarrhoea, breathing difficulties (asthma symptoms), runny nose, sneezing, and lightheadedness. In some cases, children can experience a severe allergic reaction, called anaphylaxis, which can be life-threatening.

Nasal allergies

Allergic rhinitis occurs in up to 30 per cent of adults and up to 40 per cent of children. Symptoms of allergic rhinitis include sneezing, runny nose, itchy nose and eyes and nasal congestion. Some people may also experience post-nasal drip, allergic shiners (dark circles under the eyes), and a line across the nasal bridge from an upward rubbing of the palm of the hand on the nose, a sign called the “allergic salute”.

Asthma

Allergies are a major cause of asthma, a condition that occurs in about 8 per cent of all people. Though it can occur at any age, it is most often seen in males in the pre-teen years and in females in the teenage years; asthma is the most common chronic disease in children and young adults.

Symptoms of asthma may include:

Coughing – This can be the only symptom in some people who have “cough-variant asthma.” The cough is often dry, hacking, and may be worse with allergic triggers and after exercise. The cough may only be present at night. Cold air may also trigger this symptom.

Wheezing – This is a high-pitched, music-like sound that can occur when breathing in and out by people with asthma. Wheezing usually occurs along with other asthma symptoms and may get worse with exercise and allergic triggers.

Shortness of breath – Most people with asthma feel as if they are not getting enough air at times, particularly when they physically exert themselves or when an allergic trigger is present. People with more severe asthma have shortness of breath at rest or wake-up with this symptom during the night.

Chest tightness – Some people describe this as a sensation that someone is squeezing or hugging them. Children may say that their chest hurts or feels “funny.”

Many asthmatics have symptoms with exercise; this does not necessarily mean that their asthma is severe or uncontrolled.

Treatment/Prevention

Often, the best way to treat allergies is to prevent them from occurring in the first place; this is accomplished through the avoidance of allergic triggers. However, avoidance is not always possible, such as when a person is allergic to pollen in the air. Therefore, many people with allergies require medications to treat their symptoms

Allergies are treated with medications and/or immunotherapy. There are numerous medications available for the treatment of allergies, depending on the type of allergy a person has. While medications are very effective, they do nothing to change a person’s underlying allergic disease. Immunotherapy, commonly known as allergy shots, are used for the treatment of allergic disease of the eyes (conjunctivitis), nose (rhinitis), lungs (asthma), as well as insect allergy (bee stings). Allergy shots are the only therapy available that makes a person less allergic by changing the way a person’s body deals with allergies

Tips to Avoid allergens

1. Remove pets from the bedroom, and keep them off furniture and in the outdoors as much as possible.

2. Have someone else bathe the pet at least once a week, especially if the animal is large.

3. Consider removal of carpeting from the bedroom and other common areas of the home.

4. Vacuum the carpet and floors frequently; ensuring the vacuum cleaner is equipped with a HEPA FILTER.

5. Regular and frequent washing of bed linens, pillow covers and other bedding material is a good way to avoid dust mites.

6. Removing garbage from the kitchen, keeping pet food in sealed containers, frequent cleaning of counters and kitchen floors, and using bait traps in cabinets and behind refrigerators can be helpful in eliminating cockroaches.

7. Dust mites and cockroaches both thrive in humid climates, and efforts to de-humidify (with the use of a de-humidifier and fixing water leaks), can be successful in reducing the amounts of these allergens at home.

The three general principles of allergy treatment are

• Avoidance of allergens
• Medications
• Allergy shots

Dr Shreevidya Venkatraman is a Consultant Physician at Apollo Clinic, Chennai. For health related queries email her at drshreevidyav@gmail.com.

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Dr Shreevidya Venkatraman

As soon as a child is born, the pediatrician hands over a list of immunisations that must be done for the next 12 or so years till adolescence.

Did you know that adults also need immunisation? Adult immunisation are vaccines administered to prevent a host of diseases like Hepatitis B, Tuberculosis, Diphtheria, Typhoid and others. Adult immunisation is often ignored either due to lack of awareness or shortage of time. But these vaccines taken on time can prevent debilitating health conditions and improve the quality of life to a great extent.

Given below is a typical Adult immunisation chart. Discuss this issue with your health care provider for administration.

Dr Shreevidya Venkatraman is a Consultant Physician at Apollo Clinic, Chennai. For health related queries email her at drshreevidyav@gmail.com.

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Dr Shreevidya Venkataraman

In this sub series of the Health & Fitness column we will talk about the A – Z of common health problems faced in day to day life and how we can deal with them.

Common problems – S

Sleep Disorders

Sleep disorders involve difficulties related to sleep including difficulty in falling or staying asleep, falling asleep at inappropriate times, excessive total sleep time, or abnormal behaviors associated with sleep. They can be grouped under four main categories:

• Problems with falling and staying asleep
• Problems with staying awake
• Problems with adhering to a regular sleep schedule
• Sleep-disruptive behaviors

Problems with falling and staying asleep

Insomnia includes any combinations of difficulty with falling asleep, staying asleep, intermittent wakefulness and very early morning awakening. Episodes may be transient (come and go), short-term (lasting as long as 2 to 3 weeks), or chronic (long-lasting).

Common reasons for insomnia include:

• Physical illness
• Depression
• Anxiety or stress
• Poor sleeping environment with excessive noise or light
• Caffeine
• Alcohol or other drugs
• Use of certain medications
• Heavy smoking
• Physical discomfort
• Daytime napping
• Counterproductive sleep habits:
• Early bedtimes
• Excessive time spent awake in bed

Problems with staying awake

Disorders of excessive sleepiness are called Hypersomnia. These include:

• Sleep Apnea (breath holding in sleep): affects obese people, people with ashort neck or a small jaw where breathing stops intermittently disturbing the sleep. This results in excessive daytime sleepiness.
• Narcolepsy: sleep attacks inspite of a good night’s sleep; sometimesalongwith sleep paralysis and hallucination.
• Restless Leg syndrome: uncomfortable sensation in legs during sleep and relaxation.
• Periodic limb movement disorder
• Obstructive sleep apnea
• Central Apnea
• Idiopathic hypersomnia
• Respiratory muscle weakness associated sleep disorder

Problems with adhering to a regular sleep schedule

Problems may also occur when maintaining a consistent sleep and wake schedule is disrupted. This occurs when traveling between times zones and with shift workers on rotating schedules, particularly nighttime workers.

Sleep disruption disorders include:

• Sleep state misperception (the person actually sleeps a different amount than they think they do)
• Shift work sleep disorder
• Natural short sleeper (the person sleeps less hours than normal but suffers no ill effects)
• Chronic time-zone-change syndrome
• Irregular sleep-wake syndrome

Sleep-Disruptive Behaviors

Abnormal behaviors during sleep are called parasomnias and are fairly common in children. They include:

• Sleep terror disorder
• Sleep walking
• REM sleep behavior disorder (a type of psychosis related to lack of REM sleep and lack of dreaming)

Sleep terror disorder is an abrupt awakening from sleep with fear, sweating, rapid heart rate, and confusion. Sleepwalking is usually not remembered by the person doing it, and usually affects children between 2 to 12 years of age. In adults, sleepwalking may also be caused by an organic brain syndrome, reactions to drugs, psychological disorders, and certain medical conditions.

Symptoms

• Awakening in the night
• Difficulty falling asleep
• Excessive daytime drowsiness
• Loud snoring
• Episodes of stopped breathing
• Sleep attacks during the day
• Daytime fatigue
• Depressed mood
• Anxiety
• Difficulty concentrating
• Apathy
• Irritability
• Loss of memory (or complaints of de-creased memory)
• Lower leg movements during sleep

The symptoms may vary with the particular disorder.

Treatment

• Identification of the problem
• Treatment of underlying causes like de-pression
• n Attempts to control environmental and lifestyle factors like erratic hours of wakefulness

- too much light

- too much noise

- too much caffeine or other stimulants

• Weight reduction and the administration of air under pressure through the nose
• Treatment with medication, always under supervision
• Sleep disorder clinics which help to restore normal sleeping patterns through various techniques

Guidelines

• The outcome varies with the type of disorder. Some disorders may clear up on their own.
• Complications may arise due to dependence upon sedatives or other medications prescribed for sleep disorders.
• Maintaining regular sleep habits and a quiet  sleep environment may prevent some sleep disorders

Call for an appointment with your health care provider if lack of sleep or too much sleep is interfering with your daily life. Also call if non-breathing spells are observed during sleep.

Dr Shreevidya Venkatraman is a Consultant Physician at Apollo Clinic, Chennai. For health related queries email her at drshreevidyav@gmail.com.

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