Self Healthcare- some insights

Health science is not perfect, but stakes involved in it are the highest. Doctors are
human beings, they make mistakes. Unlike other professions, doctors’ mistakes and
errors in handling patients in hospitals can take a patient’s life, and on the other
hand their care and commitment can save him. A number of high-profile studies
assert that between 120,000 and 150,000 people die every year in the US owing to
ignorance, inefficiency and callousness of doctors and other healthcare
professionals in hospitals and clinics and from communication errors between
doctors and attending nurses. How do we, the laypersons, guard against such fatal
mistakes as enumerated above and help our family members and even others
whom we care evade such incidents? The only way to minimize the incidence of
fatal mistakes by doctors involving your family is to educate self in health science.
How much should I learn and what is the goal? There is no limit to how much one
can learn. In fact, researches on many rare diseases were initiated, funded and
advanced by life-long quest to find cures by parents or dear ones of victims.
Learning health science is not the preserve of doctors only. One can learn the basic
facts about human body, particularly anatomy of gastro-intestinal (GI) tract, that of
respiratory tract up to lungs and heart, human metabolism, reproduction health,
common diseases, their prognosis and treatment. One should know what a medical
emergency is and what is to be done in case of a medical emergency. As for
example, if a family member is having a severe chest pain, what is to be done?
Everybody knows the first action and calls an ambulance service, 911 in the US, and
rush the patient to hospital. What would have been the second action that needs
some knowledge and insight? Check the pulse rate and blood pressure by a
sphygmomanometer. Before ambulance with healthcare professional arrives, give
an aspirin 325 mg immediately and a PPI like rabeprazole, pantoprazole or
esomeprazole 40mg to stop gastric irritation as aspirin can cause it and even
bleeding. This medication may save the patient’s life if it is a heart attack, but it will
not worsen patient’s condition even if the condition is not due to heart. Blood
pressure and pulse rate will give some indication of the affliction, which you can
immediately convey to the attending physician. As regards goal, your knowledge
about diseases and medicines help you communicate better with attending
physicians, watch over doctors prescribing medicines and nurses following
prescriptions and better monitor improvement. If you are sick and know your
disease, you can discuss treatment options, better decide treatment plan and
prepare yourself much better for any invasive diagnostic procedures and later
surgery.

Experts in medicine say healthy life-style, enough sleep that make you refreshed
after wake-up, healthy eating habit, not just knowledge about nutrition, exercise
and active life and the last but not the least proper stress management can not only
prolong life but also provide general wellbeing. However, this may make up 50-60%
of total health management. Genes that we inherit from our parents and over which
we have little control are responsible for the rest. However, long-held views on
genes are changing. Doctors are correcting genetic defects of unborn children inside
mothers’ wombs. Genetic therapies are curing many patients of diseases that were
hitherto incurable a few years ago. What will be our role in these complex medical
procedures? We can make a family tree and find out what diseases our parents,
grandparents and siblings are suffering from and who died of what diseases. We
may thus know our predisposition to certain diseases and that of our progenies and
let doctors know. Here comes preventive medicine to our rescue. Regular screening
for a particular disease enables early detection and treatment at the earliest period
creating conditions for higher chances of recovery. Some preventive medicines that
doctors prescribe in some conditions and supplements may defer indefinitely onset
of many diseases. Many supplements are good for health, but various studies on
supplements coming up with conflicting results only confuse us. Once Dr. Robert
Atkin became famous for his low-carb diet to lose weight, but now it is discredited.
Dr. Dean Ornish advocated for very low-fat diet for good health and long life. His
diet in most part consists of vegetables and fruits. Now red wine is in repute and so
is resveratrol. We are awash with information from various sources claiming health
benefits of many supplements. Doctors oftentimes loath to prescribe supplements
because these are not prescription drugs. While benefits of some supplements are
indisputable, we are unable to filter out mythical products from a few gems of
supplements that can really help us stay healthy. Whom do we approach then?

I am neither a doctor nor an expert in nutrition. What credentials do I have to advise

people who may be more knowledgeable than I am? I dare give advice. The
following is just a statement from a person who had suffered unimaginable pain and
from diseases for at least 40 years and gained some insights that curious readers
may glance through minding that these suggestions are no substitutes for doctors’
advice.

My grandfather had passed away at the age of 28, my mother at 53 and father at
63. I was born seven days after my mother had gone into labour. There was no
doctor, no nurse not even a midwife. My mother and I survived partly because of
luck and partly because she was a strong and healthy girl of only 16 and I was the
eldest. Nature usually bestows the eldest child of a healthy normal couple with
enormous biological advantages for survival. Among 10 siblings including me, two
expired very early-one died of tetanus because the village midwife cut his umbilical
chord with an old blade used by my father for shaving and the other boy of cholera.
Extra seven long days in mother’s womb when amniotic fluid had exhausted, my
vital organs might have been under extreme stress and weakened to a certain
extent. For reasons not detected, I had suffered from infantile diarrhea almost
continuously from infancy until the age of 5. I was rickety because of malnutrition.
My grandmother was alive then; she used to give me concoction of various herbal
extracts. At age 12, I had a severe attack with sinusitis and later developed
abdominal pain and vomiting in the morning. Thereafter, I suffered one after
another from bouts of malaria, amoebiasis, giardiasis, bacillary dysentery with
bloody feces, typhoid, seasonal flu, chicken pox, measles and occasional fever from
the age of 13 to 20. Occasionally I wad given emetine injection to stop bloody
diarrhea. At a later stage, I was taken to capital city Dhaka. I was admitted to
Dhaka Medical College hospital, the best one in town at that time. I was diagnosed
duodenal ulcer, sinusitis, dysentery/chronic diarrhea and treated with antibiotics
(Terramycin), antacids containing mostly aluminum hydroxide and magnesium
trisilicate and anti diarrheal drugs. I was hospitalized thrice for severe drug
reactions. When symptoms subsided to some extent, I was under the regular
prescription regimen of antacid and anti-cholinergic drugs. Despite medication, I
was unable to digest any fatty and spicy food. In fact, I had never been free of
abdominal pain and flatulence until I took charge of my own health. After few years,
I had also developed debilitating neck and lower back pain and treated with NSAIDs,
particularly ibuprofen. During these years of afflictions, I never gave up studies,
although at times I had to appear in examinations in sick-bed. In early 1980s I was
diagnosed in Singapore with cholelithiasis (gall-stone) and ulcerative colitis. Gall
bladder was removed and colitis treated with salazopyrin. Later I underwent another
two operations with general anesthesia to correct ano-rectal and prostate problems.
Occasionally my blood pressure fluctuated. I passed many nights with insomnia.
Sometime in late 90s, endoscopic examination of my stomach and later biopsy of
gastric tissue showed moderate gastritis caused by helicobacter pylori. Triple
therapy consisting of two antibiotics and a PPI was prescribed. Symptoms improved,
but recurred later. I consulted Helico Foundation in America, set up by one of two
Nobel laureates- Barry John Marshall (the other being J. Robin Warren), the inventor
of H. pylori responsible for ulcers in stomach and duodenum, gastritis and cancer. I
had recourse to quadruple therapy- two antibiotics, one PPI, this time esomeprazole
(purple pill) and one bismuth compound, all of which I figured out after studying
books, journals and various websites and getting a prescription from one of my
friend doctors. This time medicines worked and later investigation revealed
complete eradication of the organism. I got rid of my sinusitis by saline irrigation. I
still live with mild to moderate abdominal discomfort and mild neck and lower back
pain.

In my earlier days in service, I used to read only three magazines- Time, Newsweek
and the Economists- that every learned person reads. But I regularly read books of
eminent scientists like Enrico Fermi, John Barrow, Stephen Hawkins, Roger Penrose,
Martin Rees, Paul Dirac, Alan Guth, Brian Green, Richard Feynman, Frank Tipler, Lee
Smolin, Paul Davies, Lisa Randhel, Carl Sagan, Weinberg, Edward Witten, Leon
Lederman and Freeman Dyson and so on. My interest in astrophysics and quantum
mechanics developed during academic years, particularly reading Einstein Theory of
Relativity. But years of suffering motivated me to learn as much as possible some
fundamental elements of human body and medicines. I have been reading from late
nineties books on nutrition and medicine and following science and medical journals
to learn more about developments in medical science.
I self-medicated many times and tried many supplements, with mixed results. Now I
take only one medicine- proton-pump inhibitors (PPI), a 20 mg omeprazole now
available in the US over the counter and no more. I learnt from books and journals
and sometimes through trial and error what works best for me in particular and
what should work for others in general. Carbohydrates, fats and proteins are macro-
nutrients. Water and dietary fiber definitely form part of macro-nutrients. Vitamins,
about 80 minerals, some of which are trace and phytochemicals are micronutrients.
Do we need extra supplements in addition to what we get from food? I tried multi-
vitamin and mineral supplements and in addition vitamin C and E in 1980s and 90s.
I did not benefit much. The scientists are now saying we are getting many vitamins
and minerals from fruits and vegetables as well as from fortified cereal and many
other sources and taking large doses of vitamins and minerals can have toxic
effects. Then what should we do when experts differ and newer studies on nutrition
agents invalidate their earlier findings of some having beneficial effects, and in
other cases confirm their efficacy? What are those that have proven beneficial
effects?

I have inflammation in the gut and my C-reactive protein, marker of inflammation is

quite high. Inflammatory condition in any part of the body, particularly in arteries
can cause hypertension, diabetes, myocardial infarction, stroke and cancer and
arthritis in joints. How do I control my abdominal pain, pain in head, neck and joints
and sinusitis? I have discovered after 10-15 years of study and probe on me and few
others who are my close relatives that isoflavons (flavonoid and isoflavone groups),
particularly soy isoflavones and resveratrol do reduce inflammation and improve
health condition after long-term use. Many nutrition scientists are reaffirming that
vitamins and minerals are absorbed in our system in small quantity from
supplements, particularly for those who are healthy. Moreover it would be prudent
to get vitamins and minerals from fruits and vegetables; else vitamins and minerals
from supplements and various processed food products can raise the level of these
micronutrients in our body beyond the recommended limits causing adverse side
effects. But vulnerable group like the elderly, pregnant women and children need
supplements of selected vitamins and minerals. Zinc supplement may be given to
children, which improves immunity against cold and diarrhea. I must emphasize on
two vitamins and phytochemicals, which are anti-oxidants and protect our cell from
damage and mutation. As these two vitamins and anti-oxidants are beneficial, I wish
to elaborate on their genesis and properties. The first vitamin is D, which are of
three types- cholecalciferal (D3), calcidiol (D2) and D1. Cholecalciferol, the most
beneficial and commonly used vitamin D is the precursor of calcidiol, which in turn
is the precursor of calcitriol. Recent studies found enough evidence that D3 not only
helps absorb calcium in the body, but it is an immune booster also and is involved
in many physiological processes in cells. In cold countries, supplement of D3 1000-
2000 IU is recommended by all nutrition scientists. The other is vitamin C. Linus
Pauling, one of the most influential scientists of all times, used to take 3g vitamin C.
Despite critics’ contrary views, I have been taking vitamin C 1000mg for quite
sometime and am getting its beneficial effects. Some doctors are using in terminal
cases of cancers and full blown AIDS vitamin C intra-venous drip 100 times the
normal doses with spectacular results. But this is still under trial stage. But regular
intake of 500-1000 mg of vitamin C over a long period of time is sure to benefit us.

Another important dietary supplement is probiotics. These are helpful bacteria.

Human body consisting of 100 trillion cells is inhabited peacefully by 10 times more
microbes. Hundreds of billions of bacteria live in our small and large intestines.
Probiotics or beneficial bacteria help us produce a few vitamins, digest food
including lactose in milk, breakdown cellulose and keep harmful bacteria like
clostridium defficil and fungi under check. In fact intake of antibiotics kills both
harmful and helpful bacteria and as such opportunistic infectious agents like yeast
and fungus infect gut and many organs including tongue what we call thrash.
Combination of probiotics with antibiotics can help check proliferation of these
infections. Intake of probiotic supplement any time can reverse the unwanted
growth of these bacteria and fungi. Many types of probiotics having beneficial
effects have been discovered. Lactic acid bacteria are the most popular and
commonly used ones. They are lactobacillus acidophilus, L. casei, L. rhamnosus and
more than nine others. Then there are bifidobacterium, enterococcus and
streptococcus. Among many types, bifidum, B. longum, S. thermophilus are widely
used. Japanese are probably the first to use widely probiotics to treat many
diseases, particularly diseases involving GI tract. In fact, Japanese doctors prescribe
me probiotics. As usual, I studied about probiotics, its beneficial effects, limitations
and side effects, if any.

Numerous studies found that many diseases caused due to infections by bacteria,
viruses and fungi in early childhood and during teens leave behind a telltale sign of
inflammation and lifelong burden on the immune system. As for example, varicella
zoster virus (VZV) causes chicken pox. Even if a person is cured of the disease,
many of the viruses remain in the body even lifelong, which may be activated in old
age to cause shingles, very debilitating conditions. Epstein Barr virus and
cytomegalovirus, which cause flu-like symptoms, may remain in the body causing
inflammatory conditions and at later years arthritis and even cancer. Various kinds
of herpes viruses once enter our body and cause diseases may remain in the body
throughout whole life. Human Papilloma virus (HPV) may not cause any symptoms
initially, but it causes women cervical cancer and men some other cancers. Good
news is that vaccine against HPV is now in the market. Recently, researchers have
found evidence that prostate cancer is caused by sexually transmitted diseases
(STD). The most common STD chlamydia is caused by chlamydia trachomatis. It
may not cause any symptoms initially, but may cause serious complications later,
infecting both urinary tract and genital organs of both men and women. Promiscuity
is therefore no option for those who want to live longer in good health.

Inflammatory conditions in the body, which these infectious diseases cause, is

responsible to a great extent to a number of chronic afflictions like atherosclerosis,
heart disease, stroke, diabetes, hypertension, arthritis and even cancer. Maintaining
good hygiene in oral cavity and nostrils in many instances can fight off microbes to
gain foothold in the body in the first place. NSAIDs and Statins both reduce
inflammation and Statin alone lowers total cholesterol and seems to increase HDL.
But these medicines can cause serious side effects. Long term use of NSAIDs can
cause ulcer and bleeding. Statins can cause liver problems and in rare cares
muscular dystrophy. Long term use of isoflavons and reveratrol, which are naturally
occurring chemical substances, can have similar beneficial effects without causing
side effects that NSAIDs and Statins can cause. Another group of naturally occurring
fats can lower cholesterol, lubricate joints and provides elasticity to arteries,
capillaries and nerves and so on. These are essential fatty acids and the most
beneficial group is Omega-3s fatty acids- alpha-linolenic acid (ALA),
eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). Raw sea-fish is the
best source. Wall nut, flaxseed, avocado and egg (contains saturated fatty acids
also) are also good sources. Those who have high cholesterol and family history of
death by heart attack should take supplement of Omega-3s. Mainstream doctors are
also prescribing or advising patients to take probiotics supplement. We must not
forget to consume 5 servings of fruits and vegetables, which provide
phytochemicals or plant chemicals labeled as antioxidants. Phytochemicals are
numerous and grouped into 6 broad categories: 1) terpenes 2) thiols 3) phenols 4)
physterols 5) tocopherols and 6) isopreniods. It is not my intention to discuss in
details what oxidants are and how antioxidants like phytochemicals can neutralize
oxygen free radicals. Glucose, amino acids and fatty acids transported to cells are
oxidized by oxygen molecules existing in all cells through blood circulation and
converted to adenosine-5-triphosphate (ATP) through some complex processes.
Energy is stored between 3 phosphate bonds and released when ATP
phosphorylates and breaks off a phosphate bond. During oxidative process, many
oxygen ions are released, which are known as oxygen free radicals. Creation of
these ions is a normal process inside cells and there is built-in mechanism to
neutralize them. However, when oxygen ions accumulate and further produced due
to UV rays and other pollutants like molecules of heavy metals and food additives
and insecticides, oxidative stress is built up in cells setting in motion cascade of
reactions making unstable molecules and atoms as oxygen ions absorb electrons
from stable atoms. Moreover, during burning of fuel many free radicals like nitrogen
compounds, CO2, phosphates, sulphates are produced. These compounds together
with toxic compounds from atmosphere including food freely move inside cells. All
of them cause damage to mitochondria including its DNA, the energy producing part
of a cell and cellular membrane. These damages may ultimately change genetic
instructions embedded in DNA inside cell-nucleus. The outcome, as known to
everybody, is the onset of diseases including cancer.

In order to protect our cells from oxidative stress and free radicals, we should eat at
least 5 servings of fruits and vegetables of all kinds and drink tea- black tea, green
tea and some kinds of herbal teas. Without elaborating on what food items contain
what nutrients, it would be prudent to eat fruits, vegetables, whole grains (contain
both macro and micro nutrients), nuts, legumes, seeds, licorice, soy products like
soy milk and soy curd and tea. Then you get all micronutrients, fiber, Omega-3s
(preferred) and Omega-6s. Now add to food basket macro-nutrients protein and fat
to a lesser extent, although some protein and fat are available in the food items
mentioned earlier. Knowledge of nutrition science is not the end in itself; it is just
the beginning of a process to form habit. Good food habit needs be complemented
by smoke-free healthy life style, enough sleep to feel refreshed after wake up,
regular work out and active and stress-managed life. I have formed a good eating
habit, follow a healthy life style, don’t smoke and drink, take a regular walk, try to
sleep well and take regularly one prescription pill and a few supplements, which I
feel is keeping my blood sugar and blood pressure within normal range without
medication. My heart is functioning well without giving me any trouble. My
abdominal pain is under control and so is my arthritis. I regularly take the
supplements of soy isoflavons (100-150 mg), resveratrol (320 mg), vitamin D3
(1000 IU) and vitamin C (500-1000 mg). I occasionally take vitamin E, probiotics and
once a week supplements of multi vitamins and minerals in case any of the
micronutrients falls short of required level in my body without the apprehension that
they could reach toxic level. I maintain an ideal BMI. I am 63+ and already outlived
the age of my father and feel overall great. I know I inherited genes, some of them
being mutated that are acting against my will to live beyond 100 years, but I make
great strides to know what weapons science has provided to lengthen our lives and
apply them to my system to stay healthy and alive for many years. My philosophy is
if I can’t manage my health properly how I can manage other things in life.