Men Don’t Cry

Of course, they do! Cristiano Ronaldo and Neymar cried on the pitch in 2018, for instance. Whether that made them lesser of men or not is debatable only in a congregation of fools.

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Believe us, crying and other emotional stuff never causes any physical changes in you that strip you of your masculinity in any way! Yes, not crying and pretending to be ever-so-tough would definitely lead to worsening of psychological problems that men might have. The fact is that a large number of men do suffer from clinical depression and yet, don’t acknowledge it. Nor do a majority of men get treated for depression as they find talking about it a taboo. As a result, more men who have depression end up losing their lives to suicide than women do. In this article, we aim at identifying the symptoms that constitute and point towards the possibility of clinical depression among men.

There may be small episodes of sadness and depression in everyone’s life. However, any depression is termed as clinical depression if the symptoms last for two weeks or more. Such a depression may affect one’s work, relationship as well as physical health. Not to say, it may sometimes lead to attempted suicides. Here is a list of symptoms that may indicate depression in men.

  • Men, unlike women, feel an increased aggression and irritable behavior when in depression.
  • Men in depression may sometimes report as feeling anxious or panicky, rather than the sadness reported by women.
  • There may be a loss of interest in work or hobbies including social activity as well as loss of libido.
  • Depression in men may also be associated with a lack in ability to concentrate on things as well as remember things.
  • There may be deficient or excessive appetite as well as sleep. This may be associated with physical manifestations like tiredness, digestive disorders or pains, and aches.
  • There may be thoughts or attempts to commit suicide.

A knowledge of these symptoms may help an individual in identifying the possibility of depression. If someone has even some of these symptoms, we suggest that one should see a mental health specialist or least confide in a close relative or friend who might be able to find one for you and help you in seeking care. Remember that the treatment of depression doesn’t always involve medication. Even if you are prescribed medicine, their benefit will always outweigh the risks that you have in going without medicine.

Always remember that the first step in getting out of depression is to acknowledge that it is there and talking about it to loved ones. If you have it, you are not the only man in the world who has depression. There are many others who have it, and many are becoming better every day with the help of their close ones and friends along with proper treatment.

 

The C-Section

Caesarian section also called the C-SECTION or otherwise simply the cut from the womb is the use of surgery to deliver babies. It is especially important when a normal vaginal delivery would turn fatal to the baby or the mother.

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The need for C-Section

Reasons for surgical delivery includes obstructed labor, twin pregnancy, high blood pressure in the mother or problems related to the umbilical cord. Sometimes, the shape of the mother’s pelvis or a history of previous C-section necessitates performance of C-section. At the other times, it may be performed on request by someone, usually the mother.

Main issues that necessitate C-section are listed as follows:

  • Placental issues (Placental abruption, placenta praevia etc)
  • Failure to induce labor.
  • A condition of macrosomia (baby weighing more than 4000grams)
  • Abnormalities of umbilical cord
  • Previous medical history
  • HIV infection of mother with a high viral load.
  • STDs, which can cause infection in baby if born vaginally.
  • Hypertension in mother or baby.
  • Uterine rupture or an elevated risk.
  • Prolonged labor or failure to progress(dystopia)
  • Infertility
  • Chronic pelvic pain
  • Small bowel obstructions

Adverse outcomes

Adverse outcomes in the low-risk pregnancies occur in 9.2% of C-section. The post-operative adhesions will lead to further health issues in the near future. Added to this are the most common incisional hernias which later require surgical corrections. The wound may also get infected and further lead to more complications.

If performed in an emergency, the risk of surgery may be increased due to a number of factors. The patient’s stomach may not be empty and thus the risk of anesthesia increases. Severe blood loss may end up in the requirement of blood transfusion and post dural puncture spinal headaches.

Moreover above all these is the high chance of hysterectomies(removal of the uterus) being done. Increased incidence of postnatal depression and psychological trauma in mothers is also a fatal outcome.

The next baby

Delivery of the next child after the previous section of the cut womb can either be by the vaginal method or the elective repetition method. But this has to be taken care of because of the high risk of problems occurring in the vaginal method.

Prevention better than cure

Its always better to prevent than later searching for a cure. The things that should be done to prevent these kinds of conditions are simple enough that they can be well followed.

  • The pregnant ladies should be advised for appropriate exercising under somebody’s guidance. The lady should be healthy enough by the time of parturition.
  • Counseling sessions should be provided to the ladies who prefer for this mode rather than the normal delivery.
  • Women should be given the proper idea of what they will have to face and they should be given confidence.
  • More than everything this section should not be adopted unless there is a non-avoidable reason.

The pain now will give you a great gain for tomorrow.

Manovember!

Dear Readers,

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Many chronic and lifestyle-related diseases have a high predilection towards men [1]. Two of the most common modern epidemics – diabetes and cardiovascular disease have been consistently found to be more common in males than in females[2,3]. On the other hand, silent epidemic of depression in males has been mostly left unacknowledged and often under-diagnosed and untreated [4]. This has led to an increased incidence of suicides among men [5]. On the other hand, many cancers have a higher incidence in males as compared to females [6].

However, traditionally the domain of men’s health has either been left neglected [7] or has been limited to sexually-transmitted disease and malignancies of the prostate. Instead, due to taboos, discussion on men’s health has often been detoured into domains of physical fitness and diet [8]. Popular and commercially available literature fans these prejudices and makes venturing into men’s health issues like depression and suicide even tougher. It has been seen that men rarely if ever talk about their depression, stress and anxiety to even their closest ones. This leads to an increased impact of SAD trio and poorer outcomes. In 2017, the World Health Organization (WHO) gave the slogan – Depression, Let’s talk! in order to improve people’s attitude towards depression and make more people get themselves treated [9, 10].

As November closes in, various public health campaigns on men’s health like Movember and No-shave November have started gathering momentum. Our team at Vivact has picked this opportunity to make November a month on men’s health. Our boys have decided that they would write a blog on men’s health each week – particularly targeting the epidemic of depression among men. We will have a weekly article on this topic for the whole month as a part of our initiative named – Manovember! We invite you to discuss and think of men’s health this month to realize the goal of health for all.

Regards.

Team Vivact!

References:

  1. Sex and gender differences in health. Science & Society Series on Sex and Science. EMBO Rep. 2012;13(7):596-603. Published 2012 Jun 15. doi:10.1038/embor.2012.87
  2. Weidner, Gerdi. Why do men get more heart disease than women? An international perspective. Journal of American College Health6 (2000): 291-294.
  3. Kautzky-Willer A, Harreiter J, Pacini G. Sex and Gender Differences in Risk, Pathophysiology and Complications of Type 2 Diabetes Mellitus. Endocr Rev. 2016;37(3):278-316.
  4. Ogrodniczuk JS, Oliffe JL. Men and depression. Can Fam Physician. 2011;57(2):153-5.
  5. Ogrodniczuk J, Oliffe J, Kuhl D, Gross PA. Men’s mental health: Spaces and places that work for men. Can Fam Physician. 2016;62(6):463-4.
  6. Dorak MT, Karpuzoglu E. Gender differences in cancer susceptibility: an inadequately addressed issue. Front Genet. 2012;3:268. Published 2012 Nov 28. doi:10.3389/fgene.2012.00268
  7. Baker P, Dworkin SL, Tong S, Banks I, Shand T, Yamey G. The men’s health gap: men must be included in the global health equity agenda. Bull World Health Organ. 2014;92(8):618-20.
  8. Men’s Health: What Should We Know?. World J Mens Health. 2015;33(2):45-9.
  9. Chong, Siow Ann, Yee Ming Mok, and Mythily Subramaniam. Depression: Let’s Talk. 2017; 121-123.
  10. Behere PB, Kumar K, Behere AP. Depression: Why to talk?. Indian J Med Res. 2017;145(4):411-413.

The Doctor is busy!

“Lesser the time invested, greater the discrepancies..”

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Here! Back again with a food for thought. Now, let us begin with a statement which seems a little funny and deeply thoughtful at the same time – ‘The Doctor is Busy!’

A relatively recent study published in the British Medical Journal revealed that the doctors in India see patients for an average of mere two minutes! Doesn’t that seem to leave us wondering about the quality of healthcare we receive? Anyhow, this seems to be comparatively ok in a world where the time is considerably much variant all across the globe. Many like Bangladesh provides 48 seconds while some like Sweden gives 22.5 minutes for primary consultations.

The focus of thought today on is how it affects the large population and what it’s impact can be in the field of health sciences.

What lies behind??

Now let’s get into the core of this thought. The reasons behind the current two-minute system.

  • More patients and fewer doctors: Many a time the doctors seem to have more they can comfortably see. Thus they are forced to limit the time spent on a single one. This seems to be a common cause.
  • Unequal patient distribution: Whereas some provider facilities are overburdened, others seem to be working way below their capacity. This leads to a difference in the time provided by the doctors to the patients. For example, the lone nursing center in a big village might have more patients than a practice in the city that is surrounded by four other practices.

 

  • Bottlenecks in patient flow:  More often than not, the hospital management systems fail to manage patient flow. Thus creating bottlenecks and lines that move slowly. Therefore even when the number of doctors and patient distribution is correct, the time wasted in the process is so much that it leaves little actual time between the doctor and the patient.

 

Risk factors

The result of all these is that ultimately the patient and the healthcare as a whole suffers. The shorter consultation times have been linked to the poorer health outcomes for patients and a heightened risk of burnout for doctors, the research journal revealed. Shorter consultation time has lead to multiple drugs prescribed to the patient (polypharmacy), overuse of antibiotics etc.

The unheard grievance

Above all these is the real unheard cry. A patient cannot be cured just with medicine. The disease is not only the ill condition of the body, but it is also an indicator of our mental state too. Along with our physical condition, our mind needs a cure too. This is achieved by the power of a doctor and the power of his words. A two-minute conversation won’t suffice for this! The two minutes of which we are barely speaking can only include a mechanical talk   and not that of a friendly interaction.

What next??

The current process and flow systems should change. More time should be invested in interacting with patients, and those talks should turn out to be qualitative and relieving for the patient. The patient should be able to convey his pain, intensity of it and above all the way he feels.

Remember only  little can be achieved in less than 5 minutes, unless focus is largely on detection and management of the gross disease. Always keep in a mind, more than medicines or anything else it’s the love and friendly care of the doctor that turns out to be the best cure.

Pain at midnight…

I opened the door in a partial slumber. It was a familiar face of the lady next door. She had been my favorite one as a kid…..

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I often played with her daughter, and would sometimes have dinner at her home as my mother kept calling for me. I liked what she cooked, and moreover, it was fun! That was long time back! However, tonight her face at the door couldn’t stop me from feeling irritated.

“I couldn’t get your number, and your uncle was in immense pain….” She seemed embarrassed. It was well past midnight, and she had apparently been ringing the doorbell since past 10 minutes or so before my mother answered it.

I quietly picked up my spectacles and slipped off the front gate into the cool night breeze that made me a little less sedated. When I reached him, the very look at his face made the pain obvious. It was just a small tooth in his mouth, and his entire life hung at its mercy at that moment!

He had already taken two doses of ‘Flexon’. It was useless. There was no other painkiller that they had. It was 1am. All the medicine shops or clinics would be closed, and this guy really needed relief! The doctor inside me didn’t know what to do. We were never taught this at the college, but, sometimes our education impacts our thinking so much that we stop thinking like humans. If only we could! As I thought about all the medical procedures that could stop the pain, the lady softly murmured, “I wish I could drive….”

It just struck me, that being a doctor isn’t all you need to cure suffering. Sometimes being human could benefit more. I just rushed back, grabbed my keys and drove to the 24 hours pharmacy at the nearest hospital. On my way back, I had two thoughts in my mind. The first one was that how easy was this! The second one was that what if this were a village and we had nothing around to get the medicine from?

As I handed over the medicine and stayed with him till he was fine again, my mind was preoccupied with the thought of a person in pain at midnight in a village. Though I was able to relieve that pain for him that day, my heart goes out for all those fellow countrymen who have to spend nights in pain because they have nowhere to go. As we relieve individual pain, we sometimes forget that real healthcare will be achieved only when we have pain relief for everyone a stone throw away, even at midnight!

The Second Opinion

‘Trust is like a mirror. Once broken it never joins.’

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There we go with a most virulent query in the minds of thousands. Seeking of a second opinion from a doctor.

Seeking a second opinion is a common practice that, in a patient’s perspective, can improve accuracy for a treatment and reduce unnecessary procedures and risks. Almost 88% of the patients are seen going for a second opinion before treatment. This has many advantages and disadvantages. Now let us go into the roots of this thought.

Reasons for seeking a second opinion

It is reasonable to seek multiple opinions for your health. Inevitable discrepancies in the clinical judgment make the second opinions clinically significant and cost-effective due to their potential to reduce the costs of unnecessary expensive and invasive diagnostic & surgical procedures. The second opinion (SO) program was first introduced in the US in 1970’s by the insurance companies. Many countries including India support the SO program. Some like the UK, however, discourage it.

Types of seekers

There are mainly three types of patients who seek a second opinion.

Type 1 are the ones who go for it on their own due to trust issues or being doubtful about the doctor or the procedures that are undertaken.

Type 2 are those which are referred by the physician. It may be due to primary care physician’s doubts about diagnosis and perceived need of an expert advice.

Type 3 is by a suggestion of a third party. It may be friends, relatives or any others. This happens when someone other than the physician expresses a doubt about the treatment.

Advantages & Disadvantages

Many diagnostic discrepancies can be solved by a second opinion. A study in the Journal of Evaluation in Clinical Practise showed that only 12% of the cases under the second opinion confirmed with the original diagnosis made in the first opinion. This clearly shows that when you go for a second opinion 1 out of every 5 people gets a different outcome. This may not only save the cost of treatment, but also the risk of over/ under treatment.

The major disadvantage is that the major stem of these SO seeking mainly comes from mere anxiety and thus it leads to a trend called ‘Doctor shopping’ which can prove to be a real burden for the patients and the systems. This can happen in the absence of a regulated mechanism.

 

Refresh your thoughts

Get SO’s only done if the symptoms continue to persist,  or if diagnosed with major conditions. Go for it when you feel discomfort with the present doctor you consult.

To conclude

The need of the hour is the new mechanisms that help patients in the complicated process of seeking  SO and provide them with specialists who are able to provide them with better alternatives.

Always keep in mind that we are living in a century where knowledge comes by a single tap at the tip of our fingers. So be smart enough to move in pace with the time and technology and hence become an active part in the healthcare.

Cashless

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For even the little things can empty your pockets

When I started writing today, I was reminded of an old idiom – “Sometimes all that you need is a handful”. In this world of give and take, whatever you need comes at a cost. At least, it is true for modern healthcare in India. In our nation, sometimes an empty pocket can cost a life!

For a culture that acknowledges health as wealth, it is ironical that real wealth is destroyed because of the lack of money that should be spent on treatment. A visit to a hospital will easily unveil the current scenario of hospitals and healthcare facilities in our society. Many people are denied treatment just due to lack of money.

Lack of effective healthcare payment plans in India translates into a gross negligence of healthcare, even in well to do people. Things are even worse in the lower financial strata. Without a penny to pay even for their basic needs, thousands of people suffer from major illness without getting treated. Lakhs of people lose their lives because of denied treatment. Treatment denied is life denied!

Whereas financial capital is an important prerequisite to the sustainability of healthcare sector as an industry, a solution is required for it to become as much universally accessible as possible. In the current Indian scenario, the treatment of diseases from the common cold to dreadful cancer requires money. For a common man, this money is an important factor that determines one’s future. Many people save this money at the cost of their health. In order to reach its full potential, it is important for the healthcare industry to devise ways to make healthcare more affordable.

The old ways have proven to be full of errors, and yet, new hospitals are being established day by day, turning healthcare into an abode of rat-race where it’s certain that the common man will suffer. Let us make this a food for thought while thinking of healthcare in the future.

The Insurance Buzzword

As an alternative to the monetary woes of a common man, health insurance policies have been introduced. This has solved the issues up to a certain limit, however, it has still not been able to put the common man on the healthcare path. A major reason is their lack of knowledge.  Even though health insurance is in its infancy, and not much is known about health insurance policies, even to many people who might be able to avail it!

A reason for this might be lack of penetration of insurance into the regular small-city ‘nursing-homes’ that make a large chunk of Indian healthcare sector. Moreover, the insurance companies in India are still utilizing the traditional marketing approaches rather than adopting marketing in unison with healthcare providers and other stakeholders in healthcare industry.

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Photo by rawpixel.com on Pexels.com

A need for change

The issue of fee for service payment model in Indian healthcare is at the core of our health woes. Everyone should be able to avail healthcare facilities. There should not be more sufferers. Adequate knowledge should be provided to the common man and more policies should be introduced to avail the treatments at a much lower cost.

However, more importantly, the healthcare industry should spearhead the change in affordability and profitability of their service. Co-creating policies with the patients and the common-man and collaborating across disciplines of insurance and finance shall hold key to the next wave of cashless healthcare.

No more lives should be lost because of denied treatments. .And no more tears because of empty pockets. Let the world smile. Let us build a happy world with a healthy mind &  a healthy body. Let us all contribute to a change in healthcare!

 

Author: Ananya Chandra.