Preventive Care

This was originally posted on a saree group.

#PreventiveMedicine

Keeping my promise to discuss preventive care.

General Preventive measures are mostly commonplace knowledge that most of us are aware of but don’t always follow 😃. In reality these are more effective than anything else. 

Choose wisely starting from grocery shopping till how you cook( fried vs steamed, sautéed or grilled), what you cook, how much you cook, how much you eat and what time you eat. Instill healthy eating culture in your kids. 

Stay away from smoking, illicit drugs, and excessive alcohol.

Avoid carcinogens wherever you can. Besides tobacco, there are carcinogens in smoked foods, in MSG, in the caramel coloring used in colas, and many more. 

Have a regular regimen of exercise as well as sleep to the best extent possible.

Develop your own effective ways to handle day to day stress whether by cultivating a hobby or listening to soothing music or meditation.

Cultivate a mental culture of positive thinking. Any thought that is uncharitable does not help you, ever! So don’t give it shelter in the prime real estate of your mind! 

Suicide Prevention is an important part of Preventive Care and sadly overlooked. Watch your loved ones for subtle signs of depression. If they become withdrawn or overtly and uncharacteristically gregarious, they are sleeping too much or too little, they are inattentive, irritable or frequently missing work and assignments, turning to alcohol. Many times crying or appearing melancholic may not be the signs on the surface. Talk to mental health professionals if you suspect something is off. 

Fall and Fracture Prevention are another set of neglected issues.  Taking calcium and vitamin D supplements after the age of 50, and moderate weight bearing exercises help maintain bone health. It is a good idea to get a bone density scan 5 years after hitting menopause. Then every 3-5 years if it is normal. If it shows osteoporosis your doctor can discuss with you regarding additional medication that can help make the bones stronger.

All sodas contain phosphoric acid which is the fizz you see in the sodas. This ingredient is particularly bad for your bones. One more reason to not indulge in sodas too frequently.

Elderly people tend to have weak bones. That in addition to frailty, balance and mobility issues and poor vision create high risk for falls and fractures. A nasty hip fracture can take away whatever independence they have. It’s really no fun. To avoid these mishaps always encourage them to use mobility devices like canes or walkers, minimize clutter in their surroundings, avoid loose wires or curled carpets, diligently mop up slippery floors, encourage non skid footwear, insist that they turn on the lights at night before using the bathroom. Install railings on stairs and in showers and toilets to hold on to. Small things take you a long way to keep in good health. 

Lastly, cancer screenings.

The ones I am going to discuss are applicable to people who have no personal or family history of cancer. Those with any history of cancer would have different recommendations and guidelines. Best to talk to your doctors about them. 

Currently colon cancer screening is recommended to start at age 45 and till age 75. You may ask for a colonoscopy or a simple stool test ( checking poop for microscopic blood). Each test has its pros and cons. We can discuss it another time if anyone is interested to learn.

Women age 21 to 65 are recommended to get papsmears to screen for cervical cancer. 

For women 21-30, papsmears are recommended every 3 years. After 30, they are supplemented by HPV tests and if both pap and HPV are normal they can be repeated every 5 years until age 65. You may be called for additional testing like colposcopy if the initial test is not normal.

In India due to the greater population and cost constraints a very effective alternative initial screening test is employed instead of papsmear. It is called VIA or Visualization in Acetic Acid. Those women who show abnormality on this test are subjected to papsmears. These tests are offered free of charge at government health clinics. I encourage you to spread the word to your loved ones and make use of these tests. Often times women avoid going for these tests because they are scared to find out they may have cancer. Not doing the test is not going to stop cancer. But if you allow these tests to find the cancer in early stages your life could be saved. So truly you should be scared of not getting the tests done regularly per established guidelines.

Papsmears do NOT screen for uterine or vaginal cancers. If you are post menopausal and having new onset vaginal bleeding and got a normal papsmear you need additional testing with ultrasound and endometrial biopsy which can be done outpatient ( without hospital admission or general anesthesia). Talk to a good gynecologist if you are in such situation.

The other important available cancer screening for women is mammograms for breast cancer. You may start it at 40 and get it every 1-2 years. A self breast exam regularly and yearly clinical breast exam from your doctor is highly recommended. Mammograms are recommended till age 80, or at least 75.

For people with significant history of smoking there are guidelines for lung cancer screening with CT scan of chest. 

Most other cancers like ovarian cancer, uterine cancer, pancreatic cancer, stomach cancer, kidney or urinary bladder cancers, brain cancers do not have screening tests on a larger population basis. These are managed in individual cases depending on symptoms or history.

The entire scope of preventive medicine is huge. I have tried to touch upon just some basics. Best for you to have a good primary care doctor who can discuss with you what you are eligible for and stay on top of your health. Don’t trust Google more than a good doctor 😃. 

Now back to acquiring survival skills in absence of the official photographer. I was up early morning on the street trying catch the sunrise colors in the sky. Draped this lovely Kunbi which is a gift of love from a dear friend from Goa who was with me at Pench. Paired it with a khun fabric patchwork blouse. Got a few selfies with backdrop of the lovely skies. Then saw a neighbor taking a walk on the otherwise empty street. He happily obliged to take my picture in front of my home before carrying on with his daily walk. I better learn how to use the remote to take my own pictures before the neighbors confirm I need mental health professional’s help 😉