A sick Buddhist monk decides:

Surgery abroad only with approval of his personal doctor

Thus Ven. Monk Vegantale Rahula displayed his confidence and trust in our doctors last week.

When a visiting specialist from Singapore Dr. Wai Chun Tao Desmond (Consultant Transplant Hepatologist and

 Gastroenterologist from Asian Centre for Liver Diseases and Transplantation) at the Gleneagles Hospital, Singapore who after a thorough examination of the Ven. Monk’s condition said that his cirosis affected liver has now been damaged by about fifty percent, and needed liver transplantation to recover from his present condition and get back to his patient care work at the Cancer Hospital Maharagama commended the Thera for his decision for a second opinion from his own doctor for the transplantation, which showed the deep confidence he had in his own doctor.

Ven. Thera Vegantale Rahula, who has been carrying on this patient care service for almost 25 years now turning his temple almost into a hospital ward like, providing accommodation, food and even drugs to the needy cancer patients who are mostly from poor and average families from all over the country, including North and the East.

The Ven. Thera Rahula while profusely thanking Dr. Wai for visiting him in the temple, and carrying out the medical examination, and giving his opinion on the condition, and the need for a transplant operation to get back to his normal life and personally continue his Cancer patient care work.

Ven. Thera also thanked Attorney-at-Law Chanaka Bandarage for arranging the visit of Dr. Wai, and Doctors. Kanishka Karunaratne Director Cancer Hospital, Dr. Samadhi Rajapakse Medical Officer Cancer Hospital, Parkway Group Healthcare Marketing Manager in Sri Lanka Shuvao Hridayesh and Daily News medical page HealthWatch for arranging Dr. Wais visit to the temple.

Surgery only with personal physician’s approval

Ven. Thera however said, he would go into surgery only with the approval of his personal doctor who has been treating him up to now. Mr. Bandarage and the other doctors and Ven.

Kassapa Thera a Britisher who has become a Buddhist monk at the age of 13 years, who is now with Ven. Rahula Thera committed deeply to is patient care work, all agreed that this was a sound decision of the monk. That consultation was arranged for the next day.

Operation expenses

In the course of the discussion on operation costs involved, it was mentioned the figure would be around Singapore $ 290,000 in Sri Lanka currency about Rs. 26 million. The patient would have to stay about a month in Singapore Dr. Wai said, any operation has a certain degree of risk involved. This operation is no exception. However 85 per cent success could be assured.

Five Liver Transplants from Sri Lanka

Up to now five persons from Sri Lanka have got liver transplantations done at the Glenegles Hospital. They were all doing well. The last was a defense lawyer. Three months after surgery he is now back fighting for his clients.

Praise for Our Doctors

Dr. Wai commended our specialist doctors, placing them on par with those in the developed world. This has become possible, because they had been sent abroad to countries like USA, UK

Watermelon for heart and prostate health

Dr. Subash Chawla

The over 50 varieties of watermelon grown in more than a hundred countries the world over have been traditionally used as a food but have been found to have several medicinal properties as well.

Watermelon is sliced and eaten, or mixed with other fruits on a platter juiced to give a palatable sweet taste - an ideal alternate to the sweet carbonated drinks of today.

With a 92 per cent water content - drinking or eating watermelon, which has only a trace of fat and is low in calories - will help one shed weight over a period of time.

A favourite juice in the Mughal Courts of India the summers, almost as popular as the sherbets, in depth studies, inter alia, in India have found that watermelon is a mild laxative and also a diuretic promoting the flow of urine and helping lower high blood pressure.

It was also used traditionally in India for chronic bronchitis, painful and inflamed joints, arthritis, indigestion, diseases of the mouth and throat, constipation and for kidney and bladder stones.

One of its prime uses was for the treatment of urinary tract inflammation and benign enlargement of the prostate.

Present day research has validated several major health benefits, which were known traditionally.

Watermelon is one of the prime protectors of the prostate.

The natural chemical lycopene present gives the familiar red colour to watermelon. An antioxidant, it is a known prostate cancer fighter. Lycopene is found in tomatoes as well.

Watermelon also gives you good doses of vitamin A, vitamin C, and some potassium, calcium, iron and fibre. It is low in total and saturated fat, cholesterol and sodium.

Lycopene helps fight cholesterol as well; potassium helps fight high blood pressure and stroke.

So you have a fruit of pleasing taste that helps fight major diseases such as prostate cancer, hypertension, high cholesterol and stroke added to which it has the approval of the American Heart Association that gives it the status of a first rate heart protector.

Doctors report details of rare spasm-caused heart attacks in kids

Heart attacks in children are a rare but under-recognized problem, says a report from Ohio doctors documenting nine cases over 11 years in kids as young as 12.

All lacked common risk factors for heart problems, such as obesity, family history, high blood pressure, unhealthy cholesterol levels and drug abuse.

The cause of their heart attacks was most likely a heart spasm that briefly cut off blood supply, said Dr. John

 Lane, who wrote the report with colleague Dr. Giora Ben-Shachar of the Akron Children’s Hospital in Akron, Ohio. The spasm is also a rare cause of heart attacks in adults.

Lane called it “an under-appreciated phenomenon.” His report appears in October’s issue of the medical journal Pediatrics.

All the children were stricken between 1995 and 2006, and most were treated at the Akron hospital. Lane treated a few of the earlier patients when he was at Rainbow Babies and Children’s Hospital in Cleveland.

All but one of Lane’s patients were boys. Doctors are uncertain whether girls face a lower risk because there is little in medical literature about this type of heart attack.

Chest pain is a common symptom in children, but 95 percent of the time, it is not heart-related and it is rarely life-threatening, said Dr. Reginald Washington, a Denver children’s heart specialist.

Muscle strains and stress are among common causes of kids’ chest pain. Most heart-related chest pain in kids is caused by infections, structural abnormalities or problems other than heart attacks, Washington said.

He said the Akron doctors’ report “does a good job of telling physicians” they should not dismiss heart attack as a possibility in children.

Lane said parents should consult a doctor any time a child has sudden chest pain. A heart attack in children is typically a crushing-type pain that radiates to the arm or jaw or neck - similar to adults’ symptoms, Lane said.

It is uncertain what causes spasm-related attacks, which do not involve the issues usually seen - narrowed arteries with plaque that bursts, leading to a clot that blocks blood flow.

Some overweight children have signs of early artery disease. But it takes years for that to lead to clot-related heart attacks, said Dr. Dianne Atkins, an American Heart Association spokeswoman and pediatrics professor at the University of Iowa.

Patients in the Pediatrics report were diagnosed through blood tests that showed abnormal levels of an enzyme made by injured or dying heart tissue. Many also had abnormal heart-imaging tests. Both methods are used to diagnose heart attacks in adults.

“In most cases we didn’t see any permanent long-term injury in the heart function,” and none of the patients has experienced any long-term problems, Lane said.

AP.

Nosey Facts

1. Nose is the only organ in the body that continues growing until we die.

2. Nose smells things the best at the age of 10 years. That’s why kids notice nasty and gross smells faster than others.

3. Everyone has a unique smell (except-identical twins)

4. The sense of smell is estimated to be about 10,000 times more sensitive than the sense of taste.

5. Most humans can tell the difference between about 10,000 different odours.

6. A large nose is a mark of witty, courteous, affable, generous and liberal man.

7. Smells are surer than sights and sounds to make your heart strings crack.

(With compliments from Unichem Laboratories Ltd. India)

Letter Box

Are the saturated fats of in coconut milk or oil the same as those in animal fats?

I write with reference to what is mentioned in an article titled Red rice for heart health appearing on page 24 of the Daily News of September 8. There in you have quoted from a letter by Dr. Kalupahana where she says she accidentally came across the article titled Ceylon Medical Journal on Coconut Fats.”

One of the key points of discussion in the paper in the Ceylon Medical Journal was the question of whether the saturated fats in coconut being biochemical very different to those in animal fats are handled by the human body in the same manner as those derived from animal fats.

I do agree with Dr. Kalupahana that too much fat is bad. However, she goes on to echo the recommendations of the American Heart Association which the authors of the article have questioned.

Space does not permit me to elaborate on the question of whether criteria established in the developed countries using Caucasians is readily applicable to South Asians.

It is the fat that adds taste to our food. So some fat is necessary. Is Dr. Kaluphana claiming that other sources of fat like Soya or Sunflower or better still Olive oil are cheaper.try telling that to the poor villagers.!

The authors of the CMJ paper make a plea for more research on coconut fats and virgin coconut oil in particular. The only way to lay the ghost to rest is by doing quality research.

I would also like to make one other observation regarding what she has said. Red rice is not the staple food of most Sri Lankans. Though once again hard data is not readily available, rice is the staple but in many areas outside the South, it is white polished rice.

A.S. Dissanayake, Maningamuwa Estate, Mellawagedera.

Have a good nap after lunch

Dr. D. P. Atukorale

According to Oxford Dictionary, a nap is defined as a short sleep especially during the day. In my personal experience a 30 to 45 minutes sleep after lunch makes me very fresh and relaxed and I feel refreshed when I do my afternoon channel practice.

If my afternoon nap gets disturbed due to unavoidable circumstances such as getting a telephone call from an Intensive Care Unit, I don’t feel refreshed during my evening session. I have been “addicted” to this afternoon nap from my student days at Colombo Medical School (1958 to 1964).

There were some occasions when I have got caught napping during the afternoon lectures at Medical School especially if the lectures were uninteresting and if the lecturers read the lectures from some old set of notes as in case of the Public Health lectures.

I continued with this “bad” habit of having a nap after lunch even when I did my fellowship in Cardiology at the University Department of Cardiology at Manchester Royal Infirmary (1971-1973).

I know of a very good friend and colleague of mine who does his channel consultation from 4 p.m. to 11 p.m. in a nursing home and has a 10 minute nap at about 7 p.m. daily.

I also know of a friend of mine who frequently drives between Galle and Colombo and has a 5 to 10 minutes nap on his way to Colombo and during his return trip to Galle, after stopping his vehicle near a petrol shed.

It is common knowledge that one of the most brilliant and educated Ministers in the late President Jayawardene’s and late President Premadasa’s Cabinet of Ministers had a regular one hour nap after lunch. This late Minister is said to have given strict instructions to his sub-ordinates never to disturb him during his afternoon nap.

According to Nicholas Horrocks and Ray Pounder at the Royal College of Physicians, London “Naps are powerful means of staying refreshed both before and while on duty and naps as short as 20 to 45 minutes have been shown to provide positive benefits to shift workers.”

According to European Working Time Directive, trainee doctors (Intern medicos) should not work more than 4 nights in succession. According to a Lancet editorial, doctors working night shifts need to sleep well at home (before starting their night duty). “The nap is a doctors indispensable secret weapon to survival.”

One editor at the Lancet had once worked for a psychiatrist who had a large couch in his study which had never been used for the purpose of psycho-analysis.

This editor who had done some “research work” had found that the psychiatrist would take a 30 minute nap every day after lunch using this large couch. His rule was that he should not be disturbed on any account during his nap.”

Medical Crossword No. 29

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Fatigue is an important factor in serious road crashes

Fatigue, especially when combined with alcohol, presents a particularly high risk of road crashes resulting in death or serious injury, finds a study in this week’s BMJ.

Data from the French Ministry of Transport was used to investigate the role of fatigue in serious, single-vehicle crashes during 1994-8. About 10% of the crashes were related to fatigue and 23% to alcohol. The risk of death and severe injury was highest when alcohol and fatigue were combined.

During the daytime, fatigue. distraction and weekend (versus weekday) were significant factors associated with non-alcohol related crashes resulting in death. However, for alcohol related crashes resulting in death, only fatigue was significant.

There was also a strong relation between time of day and cause of crash, with many alcohol related crashes occurring at night, say the authors. Given that crashes related to fatigue can be difficult to identify, police officers are likely to attribute such crashes only to alcohol, even when fatigue is present, they conclude.

Compiled & Coordinated by Edward Arambewala