Sunday, October 17, 2010

Confession of a smoker

Confession of a smoker


I am a practicing Physician.

I am a doctor, who has always been preaching health & its principles to the society, schools, colleges & patients in general, for about a decade.

I am suffering from hypertension also.

And yet I would like to confess that I am a smoker.

As smoker, I have always shown a strong resistance and confrontation to the experiments for quitting.

It all started on a wonderful day of my results of second MBBS. The examination we took was a very tuff one. It was said that only 5 percent of the students cleared all the subjects. In those days, in mid eighties, the results used to be seen at any Newspaper office, on the day prior to the official results. I went to such an office of a Daily paper.

Throughout my medical education my roll number in the class used to be 13, however; my roll number for this examination was 14. There was A.T.K.T. system for the second MBBS and hence the classes for the third MBBS had begun. I was again accustomed to my usual lucky 13.

I went in side the newspaper office and asked for the result. I was provided with a photocopy of a typewritten result sheet. I searched for the number 13. It was not there in the list of passed student’s numbers. Crestfallen, dejected and gloomy; I climbed down the staircase and went to my bicycle. Suddenly I remembered that my exam number was 14………..! I climbed up in a Olympian athlete’s speed to the office again, requested the list, went again through the successful numbers and I did not believed my eyes……..number 14, my exam number was there amongst the booming numbers!

I again went hurriedly to the bicycle and ran to a friend’s house. He was alone. He said he did not pass. I was in ecstasy he was totally deflated. We went on the terrace of his home; he took out two cigarettes offered one to me and said, ‘let us celebrate your success!’ I accepted the evil, clad in the white paper. I agreed the offer, just to sympathize him. I vividly remember my act made with only intention, that he should not feel hurt.

Today, after almost thirty years, my friend has stopped smoking long back and I am still consuming packets after packets.

In all these years, my memory gives me the vibrant account of all my best moments and saccharine hours are associated with puffs of cigarette. I never smoked for the depression or gloom. Only other moments I may include were those of overwork and tiredness, which are off course out number happy happenings, now days.

I tried to avert smoking many times ditto to a famous quote by Mark Twain. The very first time, I remember, was when I got married. While going for the sacred visit to Jejuri, on the next day of the wedding, I admitted to her that I smoke. I also added that if she disdains it I would quit. To my bewilderment, she exclaimed that she would not mind and more over she added that she liked the smell of the cigarette smoke. After getting a clean chit, there was no stop no secret smoking like many of my friends, whose wives and progenies are still unaware of their vices, only because they do it surreptitiously. These gentlemen never buy their own packs, always borrow from their pals and do gargles their mouth and chew the mouth fresheners before going home. I never ever hide my weakness about smoking from my family or friends, not even from my parents. However; as a respect I never smoke in the presence of my parents or teachers or the people I revere.

Few years ago, I had a problem. I started getting palpitations after smoking. This used to occur even after inhaling the passive smoke of a passer bye on the road. I used to be symptom free if I did not smoke. After two days I began to get similar missed heart beats even after having tea, coffee, cold drinks even the popular government drink ‘Energy’. I underwent all the cardiac tests including stress test and 2-D echocardiography. Nothing was abnormal even in ECG. My physician cleverly decided to have a smoke and take an ECG. The missed beats appeared there with their ghastly ups and downs on the strip.

I immediately stopped the habit. I had to do a lot to control my concentration which used get haywire after feeling the urge to smoke. I started doing exercise, running, climbing the hill, yoga, meditation. All these workouts were going on for three months. I started feeling fresh, healthy & fit.

During this period there was a party from a hospital, for its first anniversary. I attended it. It was on a lush green lawn of a very trendy hotel. The music was going on, doctors dressed in formals were enjoying. Many of them, including I myself, came directly after their hard day schedule, some were busy in discussions about there new adventures, some were in the joke sessions with fizzling laughter. With such jolly and blissful decorum I was offered a cigarette. Engorged in a hot discussion on a current topic, I accepted it without any hesitation, unconsciously and without any conscience. After taking few puffs I realized that I am smoking and there are no palpitations!!

Again the destiny had cleared all the hindrances and I embarked on ceaseless sessions of my favorite play with fire. There after I tried to get released from this habit but with a big letdown each time. I became a confirmed addict.

I get severe cravings if I do not smoke for few hours. My temperament gets lost with all the sense of balanced behavior. My tongue becomes venomous and the voice with high pitch becomes mind piercing sword. In these frenzied & frantic moments, I have hurt many. My patients, my friends, colleagues and more often my family are amongst the worst sufferers. I have committed many illogical, vicious and destructive acts in my explosions during cravings. I have hurt people physically, demolished the precious things like a glassware set, which was collected with years of efforts by my wife. I have shattered a television set in my home. I repent a lot after such acts, but none the less it keeps on repeating.

I still remember the hell of a time when I travelled to Europe on a 16 hour journey by air with 4-5 hors added for the time for reporting and the clearance before coming out of the airport at the end. There are smoking lounges in some airports but I was ignorant of such facilities. I was under constant stress that something will ignite me during the course and I will burst out with all the paint up vengeance. During the extended hours in my medical practice, a buzz starts humming in my head. The extra-ordinary professional coolness, for which I boast myself, starts cracking. I begin behaving erratically. At such times, I take break, saying I have to go for a home visit. I fly to a tea house, because during last few years the restaurants around do not permit smoking. I relish my cigarette with a badly concocted tea at the lousy tea vendor and come back with the buzz in my head comfortably calmed down.

I understand this is an extreme case of Nicotine dependence. I have tried counseling, medicines, chewing gums, antidepressants, sedatives, even homeopathy and Dr. Bakh’s medicines also. All went in vain. I realize that this habit has to go.

Everyday I think I will quit on next Monday, first of next month, from Dasara, Gudhi Padva, my birthday; but alas I cannot do it every time I plan. I feel strongly and sturdily to quit, before it is too late.
 Please pray for me and help me if you can.

Tuesday, August 31, 2010

Transliteration in Gmail

Transliteration in Gmail तापांच्या साथीच्या विळख्यात पुणे शहर
------------- डॉ. अविनाश भोंडवे
पुणे शहर हे विद्येचे माहेरघर म्हणून ओळ्खले जायचे, ते आज तापांच्या रोगांचे नंदनवन म्हणून गणले जायला हरकत नाही. आज पुण्यामध्ये मागच्या वर्षीचा पाहुणा स्वाइन फ़्लू तर मुक्कामाला आहेच पण त्याच्या सोबतीला डेंग्यू , मलेरिया, विषमज्वर, चिकुनगुन्या, न्यूमोनिया हे जुने स्नेही देखील आवर्जून आले आहेत. सर्व पुणेकरांचा या तापांच्या साथींनी कबजा तर घेतला आहेच, पण सर्व रुग्णालये ठसाठस भरून ओसंडतायत , दवाखाने रात्री उशीरापर्यन्त आटोपत नाहियेत, औषधान्च्या दुकानान्समोर एखाद्या हाउसफ़ुल चित्रपटगृहासारखी गर्दी असते.
हे सर्व होत असताना, हे ताप टाळण्यासाठी काय करायला पाहिजे, हे समजून घेणे हा एक लेखाचा उद्देश नाही, कारण तो एखाद्या ग्रन्थाचा विषय होईल. प्राप्त परिस्थितीत या तापदायक आजारांची थोडी माहिती करून योग्य वेळी काय केले पाहिजे, हे समजून घेऊ या.
आजारांचे प्रकार
या आजारान्चे लक्षणान्प्रमाणे दोन प्रकार पाडता येतील,
१) सर्दी, खोकला आणि ताप असणे
२) सर्दी, खोकला नाही पण ताप असणे

पहिल्या प्रकारात मुख्यत्वे, साधा फ़्लू आणि स्वाइन फ़्लू येतात. या दोन्ही आजारात कडक ताप आणि सर्दी, घसा दुखणे, खोकला असणे असते. पण साध्या फ़्लूमध्ये तापाचा उतार चढाव दिवसभरात दोन तीन वेळा होतो, पण स्वाइन फ़्लू मध्ये ताप उतरतच नाही. त्यामुळे ज्या रुग्णाला वरील लक्षणे आहेत पण पहिल्या दोन दिवसात ताप अजिबात देखील उतरत नाही, अशा रुग्णाने महापालिकेच्या दवाखान्यात जाऊन त्वरित स्वाइन फ़्लू च्या गोळ्या अथवा औषध सुरू करावे. हे औषध स्वाइन फ़्लूची कुठ्लीही तपासणी न करता घ्यावे.त्याबरोबर इतर तपसण्या नन्तर करून, एखादा अन्य आजार निघाल्यास त्याची उपाय योजना देखील एकत्रितपणे सुरू ठेवावी. लक्षात ठेवा, स्वाइन फ़्लूची औषधे तो आजार नसताना घेतल्यास कु्ठलाही धोका नसतो, पण ती घेणे टाळल्यास किंवा एकदा सुरू केल्यावर बन्द केल्यास, तुम्ही मोठ्या आजाराला निमन्त्रण देता.
स्वाइन फ़्लूची औषधे खाजगी दुकानात देखील मिळतात, पण ती तशी महागही पडतात आणि महापालिकेच्या दवाखान्यात ती विनासायास मिळतात. जर तुम्ही तुमच्या वैद्यकीय सल्लागाराची चिठ्ठी घेऊन गेलात तर तुम्हाला थोडे देखील कष्ट पडणार नाहीत.
स्वाइन फ़्लू असा ताब्यात आल्यावर साधा फ़्लू असेल तर तो वैद्यकीय सल्लागाराच्या साध्या औषधानी बरा होणारच! आणि मग जर या प्रकारातले इतर आजार असतील तर ते थोड्या अधिक तपासण्या आणि काही उत्तम औषधे वापरून तुमचे डॉक्टर तुम्हाला बरे निश्चितच करतील.
दुसरा प्रकार म्हणजे रुग्णाला सर्दी, खोकला नसतो पण खूप ताप असतो. डेन्ग्यू, मलेरिया, विषमज्वर, चिकुनगुन्या हे आजार या प्रकारात येतात. या पैकी मलेरियामध्ये थन्डी भरून येते, ही थन्डी कधी कधी एवढी जोरदार असते की दोन चार जाड चादरी पान्घरल्या तरी कमी होत नाही. मात्र आज काल बऱ्याचदा मलेरियामध्ये रोज सन्ध्याकाळी थोडीशी हुडहुडी भरून येते आणि मग ताप येतो. दिवसा मग ताप अजिबात नसतो.मलेरियाच्या तापाचे निदान रक्ताच्या तपासणी मध्ये निश्चित करता येते. त्यात मलेरिया्च्या दोन पैकी कुठला प्रकार आहे ते ठरवून औषधोपचाराद्वारे तो नक्की बरा करता येतो.
डेन्ग्यूच्या तापामध्ये ताप, थोडी थन्डी येते पण अन्ग आणि हातपाय भयन्कर दुखतात. अन्गावर एक प्रकारची बारीक, लाल पण न खाजणारी पुरळ येते. य़ा वेळी त्वरित रक्त तपासणी केली तर रक्तातल्या छोट्या लाल पेशी ( प्लेटलेट्स ) खूप कमी झालेल्या दिसतात, तशीच डेन्ग्यूच्य खात्रीसाठी एक खास तपासणी, आय जी जी आणि आय जी एम ही देखील करून निदान पक्के करता येते. या तपासणीत जर या छोट्या लाल पेशी थोड्याशाच कमी असतील तर काळजीचे कारण नसते. दररोज त्या पेशीन्च्या सन्ख्येवर रक्त तपासणी करून लक्श ठेवावे लागते. जर त्या पेशी ५०,००० हून कमी झाल्यातर रुग्णाला इस्पितळात हलवावे लागते. दरम्यान रुग्णाला नाका-तोन्डातून, शौचातून अथवा लघवीवाटे रक्तस्त्राव व्हायला लागला तर आय सी यू मध्ये ठेवावे लागते. सुदैवाने सध्या अशा प्रकारच्या डेन्ग्यूचे रुग्ण कमी आहेत.
चिकुनगुन्या नावाच्या एका विचित्र आजाराने आज अनेक जण पीडित आहेत. या आजारामध्ये ताप तर येतोच पण गुडघे, घोटे, मनगटे असे मुख्य सान्धे प्रचन्ड दुखतात. हे दुखणे कधी कधी एवढे जबरदस्त असते की रुग्ण जागेवरून उठू शकत नाहीत, चालण-फिरण तर दूरच राहत. या आजारात ताप उतरल्यावर देखील काही महिने या वेदना होउन माणस बिछान्याला खिळून राह्तात. या आजाराची देखील आय जी जी चिकुनगुन्या ही एक खास तपासणीकरून निदान पक्के करता येते.
डेन्ग्यू, मलेरिया, आणि चिकुनगुन्या हे तिन्ही आजार डासान्मुळे होतात, पण त्या त्या आजारान्च्या डासान्च्या जाती वेगवेगळ्या आहेत. मलेरियाचा डास हा डबक्यान्मध्ये वाढतो, तर डेन्ग्यूचा डास छोटे खाच खळगे, निकामी टायर अशा ठिकाणी साचलेल्या पाण्यात त्याची पैदास करतो. उलटपक्शी चिकुनगुन्याचा डास मात्र साचलेल्या स्वच्छ पाण्यात म्हणजे झाडान्च्या कुन्ड्या, बागेतील पाणी, गवतावर साचलेले पाणी यात जोम धरतो. त्यामुळे यावर्षी झोपडपट्टयात आणि दाट वस्त्यन्मध्ये डेन्ग्यू आणि मलेरिया, तर उच्चभ्रू भागन्मध्ये चिकुनगुन्याची लागण जास्त असे चित्र दिसत आहे.एकूणच या साथीन्ची खरी कारण, शासकीय आणि महापालिकेच्या अयोग्य व अपुरी आरोग्य व्यवस्था हेच आहे.
विषमज्वर किंवा टायफोईड हा आजार तसा आता वर्षभर सापडत असतो, पण सध्या या तापच्या रुग्णान्च्या संख्येत बरीच वाढ झालेली दिसून येत आहे. हा आजार आतड्यान्चा असतो आणि दूषित अन्न, उघड्यावरचे पदार्थ खाल्ल्यामुळे होतो. या आजाराचे निदान रक्त तपासूनच होते, पण ते तापाच्या पाचव्या दिवशी तपासावे लागते. या आजारात ताप थोडा थोडा रोज वाढत जातो आणि नेहमी सुरवातीला दुर्लक्श होते व नन्तर आजार विकोपाला गेल्यावर रुग्ण डॉक्टरांकडे जातो. या आजाराची प्रभावी लस उपलब्ध असूनही फार थोडे नागरिक ती घेण्याबद्दल जागरूक दिसतात.
सारान्श असा की हे सर्व आजार जाणून घेऊन सर्व नागरिकानी कुठलाही ताप असला तरी सध्या घरगुती उपचार न करता योग्य वैद्यकीय सल्ला घेऊन आपल्या आरोग्याची काळजी घ्यावी. पुणे शहराचा हा रोगप्रवण पणा हा काळजीचा विषय जरूर आहे; सरकारने आपल्या सर्वान्च्या आरोग्याची जपणूक जरूर केली पहिजे; हे होईल तेंव्हा होईल; पण तो पर्यन्त तुमची काळजी तुम्हीच घ्यायला हवी!
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Saturday, May 15, 2010

Why People Work for The Associations?

Some People are born Great,
Some Achieve Greatness and on
Some, the greatness is thrust upon.’

It is a very celebrated quotation. The similar line may be constructed about leadership, replacing the word greatness. I remember this citation in a recently concluded executive committee meeting of IMA Maharashtra State in Pune. Various issues were being discussed, various arguments and counter arguments, took place, various attacks and defenses were put forth. A peculiar sentence was repeated by many stalwarts, ‘I am a practicing doctor, I do this work as a voluntary work, and you cannot expect hundred per cent accuracy in the work.’ On this I thought about the changed quotation.

When I recollect my experience in various organizations, institutes including doctors’ associations, I really wonder, what that weird reason is for which people participate in the work of any organization. What that driving force is, which causes us to get involved in an association?

After some discussion with a range of friends, I categorize them in four prototypes.

Class I- They are borne leaders, opinion makers, good planners. They lead from the front and take associations to newer and higher levels. They may be doing something very essential for their existence, may be having good medical practice, but they are and remain full time workers for their associations. In other words mimicking a famous bollywood line, ‘ Woh jahan khade hote hani, association wahin ban jaati hai.’

Class II- These people are borne with some organizational skills, have great ambition, they want to test their skills and prove their class. They also take the associations to an elevated heights. Usually they remain aloof whenever their duties are over, but help whenever they are asked for.

Class III- These people have time, they do not have any problems of earning. They join the organization, do some work, enjoy their responsibilities. They take everything in their stride and keep on increasing the active participants. These people create a great impression of the organization and increase the membership number.

Class IV- They are real troubles. It is obvious that they come to achieve the laurels only. That too, they want it by the hard work of others and Recently an experienced senior friend of mine commented that these people come here to play politics because in real politics they just cannot survive. Surprisingly and sadly, we are getting these types more in our organizations.

I feel, to achieve greatness one has to learn the qualities of great people and keep on improving your performance. And off course ONE must judge one’s qualities and decide one’s real class and also whether you are worthy of becoming somebody in the organization, before working for the associations.