I Learned from my Patient..

Today I happened to see a person a known case of severe depression on drugs. He came for a regular review. I started talking to him. He elaborated his complaints to me. I explained to him his problems and the solution to his problems. He complained about his interpersonal conflict and other issues. 

I explained to him all his issues.The interview lasted for about an hour. He seemed to be relaxed and I advised him to come for regular follow up. He said ok but was standing there waiting for me to do something. I asked him “what is your doubt?” He hesitantly came close to me and asked “sir you have not examined me? I told you I have problem I my mind. But you have not auscultated my chest. Then how will you know my problems? “ Yes his concept of mind was related to chest. I politely took my stethoscope and auscultated the chest and told him he was ok. He felt so relieved and thanked me and left the op. 

Well he taught me a lesson today. Whatever may be the case auscultation of the chest is important for the patient when he comes to a doctor irrespective of his complaint. I thank my patient to reminding me time and again its importance. I learned from him today a lesson. Let me not forget its importance.

Dr.Bevinsathya.

Hippocrates the Social Reformer

Hippocrates is said to be a great Greek scholar and physician of 400 BC. He is called as the father of western medicine. But his contribution to psychiatry is more important. He was the first person to say that mental illness is due to bodily changes and not due to demonic possessions and black magic.

Doctors and Medical students take the Hippocrates oath during their medical journey.

Though Hippocrates was not able to point the changes in the nervous system or neurotransmitters he told that mental illness is due to an imbalance in the bodily fluids. He explained that human emotions can be divided into four humors.

A) SANGUINE (Blood) - A warm, outgoing personality. Rarely loses temper and is compassionate and loving by nature.

B) PHLEGMATIC (Phlegm) - A lazy, laid-back personality. Is rarely bothered by carrying out jobs or work, and does not express many emotions. Never is emotionally intense.

C) CHOLERIC (Yellow Bile) - An angry, aggressive personality. Is often loyal, but at the same time, has a very short fuse and is impulsive by nature.

D) MELANCHOLIC (Black Bile) - A sad, despondent personality. Tends to display more reactions of negativity towards stimuli, and is often selfish and self-absorbed.

But even in 2013 people believe mental illness could be a part of black magic or demonic possessions.

The more sad part is the amount of financial loss and stress they undergo before consulting a doctor. People consult a lot of magic religious persons and lose their hope before coming to a psychiatrist. They are so drained and tried that they are not able to accept the explanation of the psychiatrist. The latter they consult the poorer is the prognosis. This is very important in case of any mental illness. So friends please don’t hesitate to come out and solve your problems as soon as possible. BE OPEN AND BE FRANK

“LETS MAKE A DIFFERENCE”

Dr.Bevinsathya.

Am i FAT.....?

Feeding and eating is the main mode of energy intake of our body. Each person has his/her own pattern of taking diet. Some are concerned about their health, some about their body shape and some about flavors and taste and so on. There are few persons who self-starve themselves to maintain their body image. It is especially very common in adolescents girls. The overall incidence is more in women than men. 

There are two important medical conditions related to eating. 1) Anorexia Nervosa  2) Bulimia Nervosa(Binge eating). 

In Anorexia Nervosa persons self starve themselves to maintain their body image. Many famous personalities like actresses and singers especially below the age of 30 have lost their lives due to anorexia nervosa. 

In Bulimia Nervosa persons go on a eating spree followed by self induced vomiting and purging to over compensate their body fat content. Beware friends it is a bad habit to have. This eating pattern can disturb your body's nutritional balance.It can lead to malnutrition, menstrual abnormalities,decreased immunity, cardiac problems,cognitive disturbances,behavioural disturbances, infertility and in severe condition lead to liver , kidney malfunction and death too. It is very important to maintain a balanced diet all through the day 24/7. 

You can calculate your BMI which is an indicator of body fat content by using a simple formula(wt/ht2). If you have doubts in your diet pattern please consult your dietician or doctor to clarify them. It is very important to stay healthy and active than a so called body image. 

"Eat healthy Stay healthy". 

LET'S MAKE A DIFFERENCE.

Dr.Bevinsathya.

SIR PLEASE IN AM AFRAID...

Few days back on a fine evening two policeman brought a wandering person to the hospital with a magistrate order under the request of his mother. The main complaint was he was very aggressive and uncontrollable by others . On examination he was irritable and not so cooperative. He was advised admission. I asked the policemen to take him to ward but the person denied to go to ward.He refused and stood ground there for around 5 hours. In the meantime i noticed the two police personnel getting very restless and trying to tell something.

One of the policeman silently came to me and told "sir we can control any murderer or a smuggler but with this person we are very afraid.Sir he is very angry.He may hurt us sir. Give him some drugs and sent him off. Why are u admitting him?". Finally the mentally ill person obeyed to the words of the doctors and nursing staff and he came to ward. He was started on medical treatment.The next day when we went for rounds we tried to to talk to the person.Suddenly a policeman came running and told "sir dont talk to him he may hurt you". I told to the the policeman that this mentally ill person is not harmful than anyother so called normal person. Well i knew one thing for sure. These police men may have been trained to deal with criminals but when it comes to dealing with persons who are mentally ill they had zero knowledge.Well i think as a public personnel all police personnel should be given a outline about mental health and how to handle mentally ill persons. 

"LET'S MAKE A DIFFERENCE"

Dr.Bevinsathya..

Branding one as a Psychic...

I would like to share an experience of one of my friends who is a psychiatrist by profession. Around the year 2001 the psychiatrist was consulted by a businessman around 50years old complaining about his wife having sleep disturbances, lack of interest in day to day activities and suspiciousness about his behavior for a month. The psychiatrist advised him to bring his wife for consultation. The businessman was very reluctant but finally agreed to bring his wife. Few days later he came with his wife for consultation. The psychiatrist talked with the wife but she never replied back. She seemed to be very depressed. She was put on medications and advised review. The business couple was very regular in their consultations and treatment schedule. Years passed by but the wife never seemed to improve even after several psychotherapy sessions. The husband was very caring and supportive all through the treatment course. The psychiatrist even appreciated the husband for his continued support to his wife but the psychiatrist was never really able to understand the real psychopathology behind her behavior.

In the year 2006 the psychiatrist went to attend a medical conference to a nearby city. He was given accommodation in a star hotel. The last day of conference he was offered a party in the hotel by the organisers.In the party he noticed the hotel servants giving special attention to one specific person. The man seemed quite familiar to the psychiatrist. Yes the man was none other than the businessman who used to bring his wife for treatment. The businessman was accompanied by a young girl .The psychiatrist was very curious and enquired the hotel officials about the person. They told he was their prime customer and the girl was his personal assistant. The organizers told the person was a regular customer in their hotel. The psychiatrist was eager to speak to the person but left to his hometown without identifying himself. He had many unanswered questions in his mind.

Few months later the businessman brought his wife for treatment as usual. The psychiatrist asked the businessman to wait outside and started to talk to his wife. He shared his experience about her husband in the hotel with her. As he mentioned the incident for the very first time in five years the lady started to cry. The psychiatrist probed further. The wife started to narrate her problem. Few years back she has once incidentally noticed her husband sharing bed with another woman in their house. She argued about that to him. She called her relatives to help her. But the husband had a very good name with the relatives so none was prepared to listen to her. The businessman took it to his advantage. He started to consult a few psychiatrists before coming to him to brand her a mentally ill person. The psychiatrist asked” why didn’t you tell me the reason in your previous interviews?” She told her husband threatened to divorce her and even harm her if she reveals the truth. The psychiatrist consoled her and asked the businessman to come.

He told him “your wife is completely cured of her illness. She doesn’t want to take medications anymore.” The businessman’s face turned red. He tried to convince the psychiatrist saying she still had sleep disturbances and anger outbursts. The psychiatrist advised the businessman to come for follow up two weeks later. But he never returned. The psychiatrist now feels the husband would have gone to any other mental professional to brand the poor lady. He still regrets his decision to have sent the businessman away.He everyday thinks about the poor lady whom he could not help.

What could have he done to help the poor lady any suggestions?

LETS make the Difference.

Dr.Bevinsathya..

World Mental Health Day 10/10

Today ( 10/10 ) is world mental health day. The theme for this year is Mental Health and Older Adults. I personally feel we have not understood the meaning of this theme .Well if we had understood it there won’t be any old age homes popping up here and there every day. 

Few days back I had a chance to visit an old age home. It had inmate occupancy of fifty people. First I slowly walked around the home seeing most old people sitting lonely and a few talking to each other. In the kitchen few old women were cutting vegetables. Then I came to the main hall. I talked to a few persons over there. The first person was a retired clerk from railway who was brought here by his own son one year back. His son resides just a few kilometers away from the old age home. I asked the person" why did your son bring you here? He cleared his throat a bit and replied am a diabetic patient . I am not able to do my day to day work. So my daughter in law forced my son to bring me here". I spoke with him for a few more minutes before moving on to the next patient. 

The next person was the senior most person of the old age home. He was an eight nine year old healthy man
whose son works as a general manager in postal department. I asked him "when did u come here?".He smiled at me. He asked me "Who are you?"I introduced myself. Then he started to speak."I am a retired teacher. My only son is in a very big post in postal dept.He is very busy so he was not able to take care of me. So he sent me here two years back with 200 rupees in my hand. I am not a pensioner. But my son sends me Rs500 every month as pocket money for my expense. I am happy here". He was very active and happy all through the interview. Then we organized a meeting for all the inmates in a hall. 

I noticed one old woman sitting lonely not involved in the meeting. I went her and started to speak to her. She stopped me and asked "wait tell me when will my son come to see me?” I asked her when he last came to see her. She cried immediately and replied back “on the day of admission 15years back. He went to Sudan with his family. He is a doctor ".I had no words to console her. I started to talk to the gathering. I asked them “are you happy here?” They all told together that they were happy. After an interactive session finally at the end I asked them a sensitive question."Okay I know you are all happy here. But if one day your son or daughter realize their mistake and come to take you back what will you do?. There was a period of silence for about five minutes. After that one old woman from the front corner stood up and told" who does not like their children? I love them above all. After my husband's death I stood alone to save my family of three female children. Now each one of them are married and well settled. But now no one wants me. I like to live and die here itself." There was an eruption of claps from all the inmates.

 Friends I noticed one common thing in all the inmates. Their children were all well settled and financially sound but they have left their parents in these old age homes which run by charity.”Are we doing justice to our self by doing so and neglecting our parents who have carried us, cried for us, prayed for us and finally sacrificed their needs for us? I was so unlucky to lose my grandparents at a very early age. I remember my parents who have sacrificed a lot for me and my brother in shaping our careers. How can I forget them? How Can I kick the ladder which helped me to go to higher heights? The day we feel the importance to care our elderly ones will be the day we become human beings. We extract all their energy when we need it but when they are tried and crumbled and need our energy we turn our backs. I think it is the duty of every one of us to repay our elderly parents with care and affection in their second childhood rather than blaming them for their shortfalls. By doing so and giving them moral support is very much necessary for them to have a normal mental life. Treat them and love them as you do with your children. Well friends think for yourself “have I ignored my parents?”And act immediately on this day because you maybe the next in line. Yes your children are watching you closely. It is never too late. Thank you.

LET’S MAKE A DIFFERENCE.

Dr. Bevinsathya.

Mama i dont need Breakfast..

In our day to day life we are so busy that we tend to skip our breakfast. Breakfast is defined as breaking the previous night fast. Breakfast is a necessary component of every individual's daily routine schedule. People particularly children run away to school skipping breakfast, but beware children skipping breakfast in a regular basis tend to have impaired concentration, attention and poor memory and even behavioural abnormalities more than the children who take breakfast.

A famous quote "eat like a king in morning,eat like a prince in noon and eat like peasant in night" is done in the reverse order by many people.Some people even think they can reduce weight by skipping breakfast. But studies say people skipping breakfast are more prone for risk of diabetes,obesity ,insomnia,acid peptic disease and other related problems in near future.So friends spare some time and take your breakfast regularly to avoid any unneccessary complications....

Dr. Bevinsathya.