DR. BALABHAI NANAVATI HOSPITAL NEWSLETTERVOL. 23 JAN - MAR’ 2011

Wish you all a very happy& prosperous new year!

The goal of mankind is knowledge… Now this knowledge is inherent in man. No knowledge comes from outside: it is all inside. What we say a man ‘knows’, should, in strict psychological language, be what he ‘discovers’ or ‘unveils’; what man ‘learns’ is really what he discovers by taking the cover off his own soul, which is a mine of infinite knowledge.”

- Swami Vivekananda

EDITORIAL :Celebrating new year in a way is reflecting on the year gone bye and to look ahead with hope and anticipation. Our hospital in its march towards excellence has added few more feathers in its cap-state-of-the-art 64 slice PET CT with unlimited molecular imaging capabilities is the first of its kind in our country, the revamping of our operation theatres equipped with high tech facilities are to name a few. We have recently concluded NABH accreditation process successfully. We are awaiting the final ‘certificate’.

The entire hospital worked in unison to achieve the goal of NABH accreditation. We reaffirm our commitment to provide healing touch to all those who walk in through our portals.Life is not a spectacle or a feast; it is a predicament said American philosopher George Santayana. Well, that is what the American philosophy thought of our journey on this planet. But when the clock strikes 12 in the night cries of joy rant the air, when we look ahead in to the future, it is not with any foreboding but with joy and hope that 2011 will bring health and happiness to all. It is the right time to achieve your goals and dreams. Life shall not be predicament but series of magical moments. We wish you all those precious magical moments.

INSPIRATIONAL STORY :The Story of the ButterflyA man found a cocoon of a butterfly.One day a small opening appeared.He sat and watched the butterfly for several hoursas it struggled to squeeze its body through the tiny hole.Then it stopped, as if it couldn't go further. So the man decided to help the butterfly.He took a pair of scissors and snipped off the remaining bits of cocoon. The butterfly emerged easily but it had a swollen body and shriveled wings. The man continued to watch it, expecting that any minute the wings would enlarge and expand enough to support the body, Neither happened! In fact the butterfly spent the rest of its life crawling around. It was never able to fly. What the man in his kindness and haste did not understand: The restricting cocoon and the struggle required by the butterfly to get through the opening was a way of forcing the fluid from the body into the wings so that it would be ready for flight once that was achieved. Sometimes struggles are exactly what we need in our lives. Going through life with no obstacles would cripple us. We will not be as strong as we could have been and we would never fly.

On 13th December 2010, Dr. Kalpana Sarangi, head of the Cosmetology Department organized a “Workshop on Fillers” to commemorate the second anniversary of the centre. Discounted coupons for fillers and treatment packages were given to the attendees to enable them to avail the various facilities at the centre (details at the last page).

CME on “MRI with focus on film reading” was organized on 4th and 5th December 2010 for resident doctors of Neurology and Neurosurgery. Around 65 delegates attended this knowledge packed session conducted by our team of consultants from MRI centre.

The Brain Tumor Awareness Week was celebrated around the world from 31st October to 6th November 2010, The team of consultants from MRI Centre,Neurosurgery & Oncology took an initiative to organize an “Awareness and education program on brain tumor its diagnosis and treatment,” for the patients and the common people. The programme was highly appreciated by the attendees since it was informative and entertaining. The hospital staff and their friends presented few songs with music, Warli artists were invited from Vikramgadh, they described and demonstrated the Warli art. Patients also participated by making some drawings and narrating their survival stories.

Advanced Center for Radiation Oncology is an additional jewel in the crown of our hospital. On 20th November 2010, ACRO celebrated the foundation day, to commemorate the memory of Dr. D.J.Jussawala, a doyen in the field of Oncology and Smt. Sarojben Jhaveri whose memory inspired the creation of ACRO.Dr. Prafull Desai and Dr. M. G. Deo were awarded the orations for this year and Dr. Farokh Udwadia was the chief guest. It was a glittering evening of academic exchanges & fellowship. ACRO foundation day is organized annually by Dr. Nagraj Huilgol, Dr. Sanjay Dudhat & the entire Oncology team of Nanavati Hospital.

NEWS UPDATE :

On 22nd & 29th October 2010, Blood Donation camp was organized for Punj Lloyd Ltd at Kuber Barge and Andheri office. The response was phenomenal, we succeeded in collecting 86 units of blood!

MEDICAL UPDATE :Counselling for patients with “Cancer”Dr. Sanjay Dudhat, M.S. (Consultant Surgical Oncologist)

The explosion of information about cancer in public - domain has led to more informedpatients. The doctor with his experience and formal knowledge is expected to help patients to weed chaff from the grain. A good communication skill is an asset.

What Is Counselling?Counselling is a special form of helping and a person with cancer often requires such help tounderstand the problems as a result of the physical and psychological threats provoked by diagnosis of cancer and its treatment. Patients may also need help with readjusting to changes in body image and lifestyle. Counselling is required at many stages of diagnosis and treatment in Oncology, for example, it is always difficult to disclose the diagnosis of Cancer to the patient and relatives. How to disclose and explain is an art of counselling. Counselling makes treatment easier by increasing morale of the patients.

Different forms of Counselling Directive Counselling - here the counsellor acts prescriptively, directing the behaviour of the patient wanting help.

Informative Counselling - it entails providing information, giving help with decision making and understanding.

Confrontational Counselling - means challenging unhealthy thinking or coping strategies that are hindering the patient to come to terms with the problem, providing feedback to enable the patient to adopt and recognize negative thinking themselves.

Cathartic Counselling - means permitting the patients to express and release hidden thoughts, fears and guilt thus, encouraging better understanding.

Catalytic Counselling - means being reflective and encouraging patients to establish their own goals thus, promoting sense of control.

Supportive Counselling - means providing acceptance and having empathy.

How does Counselling helps?The speed and complexity of modern life continue to increase as do people’s expectations from it. Coping well requires autonomous, flexible thinking and clear decisions. Sometimes it may be difficult to express our feelings, the patient may be frightened or upset. It is often

easier to talk to a professional person then your family or friends. Counselling offers you a time and place to explore emotional issues in confidence, where you can talk and make sense of your feelings.It may help you to explore different ways of looking at the problem and coping, it will also help in finding ways of talking about your illness to others. In the counselling process, the counsellor provides love, safety and attention necessary for the patients for example, taking decision for breast conservation versus mastectomy, complete nephrectomy or partialnephrectomy, colostomy either temporary or permanent, many times it is difficult for the patients as well as relatives. Here proper counselling and good communication between the clinician and patient will enable the doctor to plan the desired treatment.

Counselling SkillsAppropriate counselling is essential to get a proper treatment outcome. One has to take real good efforts to become a good counsellor, follow certain do’s & don’t’s. It is demanding to be a good counsellor. Counselling skills are honed with considerable education and experience. Counselling helps individuals to realize oneself. It helps them make decisions without prejudice.

The Counsellor must have following skills

listening

paying attention

accept patients feelings

understand the patients world and feelings

think about the patient

Counsellor should not argue, dwell on their own difficulties, solving the problem and making them dependent.

Counselling in specific conditions of OncologyIn Head and Neck cancer, while undergoing supra major surgeries like commandooperations with reconstruction problems of swallowing, cosmesis, tracheostomy, long term nasogasric feeding and other functional aspects should be discussed with the patients and relatives. Total laryngectomy patients must have pre and post treatment counselling regarding voice rehabilitation. In Breast cancer, pros and cons of breast conservation versus mastectomy should be explained so that patient can choose the treatment easily. In Rectal cancer treatment, need of colostomy either temporary or permanent colostomy

must be explained properly to the patient. Counselling regarding the type of colostomy, care of colostomy will definitely result in its acceptance as well as reducing fear and anxiety.Counselling is required for patients undergoing Chemotherapy as there are lot of myths regarding this treatment. How does chemotherapy work, its side effects and treatment should be discussed before starting the therapy. It will increase the acceptance of therapy as well as morale of the patients.In young male patients on chemotherapy, counselling for sperm preservation is required as chemotherapy may cause damage to the sperms. Sexual counselling is an important aspect in cancer treatment e.g painful intercourse after pelvic radiation therapy, decrease in sexual desire etc.

SummaryGlobally the cancer incidence and its detection is rising. Advances in Cancer treatment has increased the survival & decreased the morbidity and mortality rates. Counselling becomes an integral part of the treatment in order to get better results. Evaluation of the possible benefits of counselling is vital and encouraging. Counsellor must have proper training and knowledge to help, support and encourage the patients which will increase the acceptance of the diagnosis of Cancer and its treatment.

HEALTH CAPSULE :

The chill is back and so is the havoc that the weather plays with our skin and body.Dehydration and over dryness of upper crust of the skin prompts us to opt for moisturizers, cold creams and sun screens available in the market. So, before picking up just anything, it's important to understand the behaviour of the skin during the season :

Dry windy condition makes our skin lose moistness of the topmost layer making it more prone to allergies, pigmentations and fine wrinkle lines.

Skin pores open up, leading to a condition fit for catching infections.

Broken skin on the cheeks makes it itchy and sensitive.

Dullness and loss of fairness is common in winters.

Fruits contain essential vitamins and minerals that are good for our healthy skin. Some winter skin care tips with fruits are as follows :

Orange juice helps to make instant glow of our skin. Apply the juice in cotton on your face, neck and hand. Leave it for ten minutes and wash it off with plain water.

Mix one tablespoon of fresh apple juice with one fourth teaspoon of lime juice. It can be a good refreshing tonic for the skin. You can use it as an effective skin cleanser.

Mix one medium very ripe tomato with one cup of un-boiled milk. Apply it on your face and neck. Leave it for fifteen minutes and wash it off. It’s also a good cleanser.

Make a paste of papaya, strawberry, melon and banana and rub it on your face. Leave it for ten minutes for the best result.

Mix one teaspoon of lemon juice with one teaspoon of honey and a half cup of water. Massage into your skin after bathing. It’s a great natural moisturizer.

Grapes are great for the skin. Apply grape juice in cotton on your face to remove dark spots.

Amla is a great source of vitamin C. It helps to nourish our skin. So, take amla daily to replenish skin and also drink at least eight glasses of water every day to overcome the water loss from the skin in this season.

Watermelon helps smooth your skin; the fruit finds its use even during winter. Skin blemishes are effectively reduced by Watermelons hence the fruit is rich in Vitamin A, B and C, which keeps the skin fresh, hydrated and radiant.

∙ MoisturizingWinters bring low temperatures, cool winds and low humidity. Our skin without adequate humidity gets dehydrated and fragile. The best way to tackle skin dryness is by applying generous doses of moisturizers after taking a bath. Remember to rub the cream along the direction of the hair follicles.Choose a moisturizer or a cold cream that contains oil because the skin isn’t producing the required oils to keep the skin hydrated. A homemade moisturizing mask is made by mixing 1 teaspoon of milk with 1 tablespoon of honey and keeping it on for 20 minutes before washing off. You can also massage your body with olive oil after bath or before sleeping, this will make your skin supple.A good petroleum jelly will be an effective cover over your lips against the cold weather. Butter is effective in curing chapped lips and renders an extra softness.

∙ ExfoliatingFor your skin to absorb more moisture, you need to exfoliate that is remove the existing layer of old cells. Now, remember to be gentle on this one as you can harm your skin if

you are too forceful. You can use cosmetic products or use natural exfoliators like lime juice with sugar or oatmeal in the milk which also gives your skin a smooth texture.

∙ HydratingWater is important no matter what time of year it is, but it is extremely important in the winter. You should drink at least eight glasses of water a day to replenish the water lost out of your skin by the winter air.

∙ Insuring a smileYou want to smile but your lips curve to a frown instead due to the dryness. Winters also bring the worst out of our lips which need immediate attention. Use a highly moisturizing lip balm. Don’t use one with menthol as you will tend to lick it and that dries out the lips even more. Also exfoliate the lips with toothbrush and "brush" your lips in a circular motion, this will remove the dead flakes and leave your lips soft and supple.

∙ Loving your feetDuring winters your feet tend to feel left out with all the attention that your face and hands get. They end up looking dry with cracks in the sole. What do you do? Apply an anti crack cream everyday and moisturize it. Wear socks to protect them from extreme coolness.

∙ Eating rightEat plenty of vegetables and fruits in winter especially the ones which are rich in protein, vitamin A, B1 and B2. These foods include-dairy products, whole grain products, eggs, meat, legumes, and green leafy vegetables. By consuming these types of foods, you can help your skin build up a defense against the elements along with your regular skin care regimen.Intake of liquids helps your skin to retain the essential oils automatically and acts as a naturalprotection against dryness.Make sure you consume diet rich in vitamin C and vitamin E, which are essential to keep the skin soft and supple. Though most of the modern skin care products contain vitamin E, it is advised to drink milk and eat the white of an egg to assure regular intake of vitamin E.

∙ Soaking up the SunNeither our grandmother nor our mother used a cold cream in winter. Oil massages and sitting in the sun is the maximum limit they went to. This practice not only helps in absorbing heat of the sun but also helps in synthesizing Vitamin D that protects the bones.

∙ HairBefore the winter winds can work havoc with your hair, expose your hair to deep conditioning. Since the cold weather causes to dry your hair, massage your hair in aloe Vera juice for a few minutes. This will restore its softness.You can also treat your hair with oil massage once or twice a week. Olive oil can work wonders in reinforcing moisture to your hair. Heat the oil before using and allow it to soak for a time lesser than the time you allot for the summer season. Too long a period of soaking hair in oil can get you ill. If you are used to treating your hair with herbal extracts or herbal oil do not soak it for a long time. Herbal ingredients are mostly cooling agents that are more suitable for the summer. Keep away from washing your hair too frequently.Woolen clothing like hats, scarves and turtlenecks can cause damage to your hairline. Since they can cause breakage, first cover your hair with a silk scarf before exposing it to winter wraps.It is the appropriate time for split ends to work their way up to the hair shafts. Hence trim your split ends.Style your hair with a braid, twist or a knot. Try Keeping away from letting your hair open and wild, as the cold winds can play rough on your hair.Avoid exposing your hair to frequent coloring, streaking, or ironing as they can rob your hair off its moisture and it is advisable to avoid heating appliances on your hair.Expose your hair to natural drying. Keep away from blow dryers. If you have to use, use one with a hood.Always cover your hair with a silk fabric to guard it from the chill winds.

Winter Ailments Home Remedies And Cures To combat winter allergies, simmer half teaspoon each of Echinacea root and marshmallow in two cups of water. Remove from heat and add one tsp of chamomile flowers, half a teaspoon of peppermint leaf, and a quarter teaspoon of ginger rhizome. Allow this concoction to steep for 15 minutes before straining it to retain the essence. Drink a cup or two cups of this herbal tea as a remedy for skin allergies.

Another great home remedy is lime juice mixed with crushed poppy seeds and water in equal proportions. Rub this paste on affected parts.

The juices of herbs like cassia, henna and holy basil can be applied topically to provide relief from skin allergens.

An all juice diet for four days coupled with herbs rich in vitamin C such as Acerola cherry and Rose hips help to build immunity and keep winter ailments at bay.

Breathing exercise provide ample oxygen to the body, which can flush toxins out of the body. Practice deep breathing for 15 minutes a day.

Two teaspoons of ginger juice mixed with one teaspoon of honey and a pinch of turmeric, if had two to three times a day, can help to relieve coughs.

Steam inhalations infused with Eucalyptus oil are a great way of clearing blocked sinuses.

Sage leaf provides relief from influenza related inflammation of the mucous membrane.

Two teaspoons each of honey and apple cider vinegar in hot water should be consumed every morning for relief from arthritic pains.

Hot vinegar or sandalwood paste can be applied topically to aching muscles and joints.

Ginkoba Biloba, Cayenne pepper, Evening Primrose Oil, Fish Oil, Rose Hips and Acerola Cherry, taken orally, help to boost the circulatory system.

Winter Ailment DietThe digestive capabilities are at their peak in the winter season and rich foods can beconsumed with ease. Nutritious and energy rich winter foods must be consumed to help the body store energy for the remaining year. Warm foods such as soups, casseroles, stews, dried fruits and fruits like papaya, pomegranate and apples make for excellent choices. Milk and other dairy products are highly recommended since they have good bacteria, which build immunity. Add herbs like garlic, Echinacea, saffron, which build immunity and provide warmth to your diet. Sour and pungent foods, excess caffeine and refined foods are best if avoided. The most helpful food in improving the moisture of the skin on winter is vegetables that are green and leafy. You must also consider drinking fruit juices daily since it helps in making your skin soft.

Other Suggestions For Winter AilmentsMost importantly, ensure that you keep yourself warm and snug throughout these cold months.When you go out ensure that your head, ears and chest are warmly covered.If anyone in the house has a cold, wash your hands every time you come into contact with that person.Keep yourself healthy, fit, happy and rejoice in the festivities that are a part and parcel of every winter.

Our tradition of medical excellence goes back over five decades and has been catalysed by a commitment to serving the general needs of our community and the individual needs of our patrons. We are glad to offer you the health check-up schemes at competitive rates.

Dental Department :At our Dental Department, comprehensive dental schemes have been specially created to help you maintain dental care and hygiene. Just give us a call & our eminent consultants would help you plan your dental treatment.

“PEACE OF MIND PLAN” offers the following schemes as below :

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EDITORIAL TEAM:MARKETING & PUBLIC RELATIONS DEPARTMENT

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