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BODY TALK

Dr. R.K.Modi tells you about six aches you shouldn't ignore

STOMACH ACHE

Tummy trouble is common in Mumbai where people have irregular eating hours and the temptation of street food. If you're a woman in child-bearing years, a stomach ache could singnal an ovarian cyst. A persistent stomach ache which only gets worse such that the pain then trickles down to your lower back, is cause for concern. Often the pain is accompained by problems in bowel movemnets(constipation or diarrhoea). The best way to rule out the possibility is to get an ultrasound which can detect a cyst immediately. If caught early, an oral tablet can take care of the situation. However, if the cyst grows in size then a key-holes surgery may be required.

BACKACHE

Most of us suffer from backache and working all day on the computer only aggravates the problem. However, if your backache starts radiating downwards to the genitals and is no longer a dull ache but a sharp pain, then you need to see your doctor as soon as possible. Sometimes the pain may last for just a few minutes, at other times it may last for hours on end. Such piercing pain could be the result of kidney stones, which usually affects adults. It can be detected by means of an x-ray, ultra sound and urine examination.

JAW PAIN

Have you ever felt this annoying dull ache in the jaw?In most cases, it is because the temporomandibular joint (jaw joint) is overworked and the pain usually fades away with time. However, if it's repetitive and accompanied by a clicking sound as you open and close your mouth, it could point to injury of the jaw joint. A general physician can detect the problem by means of an X-ray. Treatment lies in oral medication.

JOINT PAIN

Most adults over 50 years of age complain of pain in the joints. Commonly, this is a dull ache in the knees which increase with movement or a similar ache in the small joints of the fingers on any sort of hand movement. If the pain persists and increases, then you need to see an orthopaedic physician immediately. An X-ray and a bone density test can point to osteo-arthritis or rheumatoid arthritis which are both bone degenerative diseases. Both problems are more common in women than in men as bone density often decrease after menopause. The disease cannot be completely cured byt it progression can be halted through physiotherapy and steroids. In extreme cases knee -replacement surgery may be required.

PAIN IN THE BIG TOE

Pain in the big toe gout. Gout results from excess uric acid crystals deposited in the joint. Over time the pain becomes excruciating an daffects movement.The problem is more common in adults over the age of 30. Gout can be detected through X-ray and blood test and treatment involves oral medication.

PAIN AROUND THE TEMPLES

Often a headache is just that-a selflimiting ache in the head. However, if the pain is restricted to the temples and is a piercing pain, you need to see a doctor as it could be temporal arthritis. The condition is more likely to occur in adults over 50 and is repetitive at regular interval, at times lasting just a few minutes. During this time, the blood vessels of the scalp get dilated and the temples are sensitive to touch. Treatment involves steroids.

Aches, Pain and the PC

Keep Backache and Eye Strain At Bay With The Right Kind Of PC Accessories

It's official. Hunching over a computer all day beats lifting and carrying heavy things as the number one cause of back trouble, says a recent survey by the British Chiropractic Association. The survey found that people who sit in front of a screen all day are more likely to suffer back pain than manual labourers.

But that's not all. There are other joys that come with staring at the screen all day, chat toppers being the ever faithful eyestrain, twisted wrist ailments and neck trouble.

Rest easy, though, for here are bunch of smart gizmos and tweaks that promise to ease the aches and pains of the digital world.

Ergonomic keyboards and mice

Jabbing away at your keyboard is the fastest way to bring on carpal-tunnel syndrome, a painful condition that creates pressure and pain in the fingers, hands and wrists. It is caused by repetitive and strenuous use of the fingures and hands, which inflammation the median nerve that runs through the wrist area.

If you can't avoid typing all dayl, at least make sure that you use best-of-breed ergonomic key-boards.

Kinesis Maxim or Microsoft, for instance, have models that you can adjust to split and rise in the middle, keeping your wrists in a more natural, less stressful position.

SafeType takes this one step further, and brings split halves keyboards that stand vertically. These might look strange, but they promise to eliminate all kinds of keyboard-related stress.

Wrist ailments are also common with people who make heavy use of the mouse. Easy-on-the-hands mice that require more thumb than index-figure use are good alternatives, as are trackball models.

Try varieties such as vertically-oriented mice from 3M Ergonomic Mouse or Evoluent Vertical Mouse 2, which also comes in a left-handed version for lefties.

Monitor

Displays often come with their refresh rates set too low-60 HZ, or 60 screen refreshes per second-which makes the screen flicker. Turning up the rate to about 72 or 85 Hz will reduce flicker and in turn, eyestrain.

But trying to set the rate just right can get confusing. That's where a program like RefreshForce (www.pagehosting.co.uk/rf/) can come in handy. A free tool, RefreshForce will let you set your monitor's refresh rate in a blink.

Next, if you're still using a CRT monitor, consider switching to an LCD. Not only are LCDs flicker-free, but they also produce less glare than CRTs. Samsung Synchmaster, Dell Ultrasharp or Viewsonic are good options to consider.

While you are at it, make sure you turn on ClearType to see a remarkable improvement in your display's font resolution. This feature is available in Windows XP

By dafult, ClearType is switched off, but it's simple to turn it on:

Right-click the desktop and select the "Properties" option.

Then select'Appearance', followed by 'Effects'.

Check 'Use the following method to smooth edges of screen fonts'.

Now select "ClearType'from the drop-down list and click "OK" Twice.

Phone Accessories

A phone can be a real pain in the neck, especially if you are the kinds who cradles a handset between your shoulder and ear as you type.

For those die-hard multi-taskers, we suggest hands-free headsets from companies such as Labtec that let you switch between your PC's audio and your telephone at the push of a button.

Alternatively, you could look at wireless options such as 'Plantronics' CT-10, which will allow you to take a small walk while you speak on the phone.

And Some Posturing

Finally, there's a right way and wrong way to position yourself for long spells in front of the PC. Proper monitor placement tops this'correct posture'chart.

First, the best placement for your monitor is where it is sitting directly in front of you-it shouldn't be placed off centre to any one side, as then, you would end up turning your neck to view the screen. Do that all day long, and you are bound to end up with a crick in the neck.

The thumb rule is that your eyes should be level with a point about two inches below the top of the monitor. Most monitors come with adjustable stands, but if yours doesn't, stack up a few journals under it or get a monitor stand to get the height right.

While on the keyboard, type with your elbows at your sides, with shoulders relaxed, and wrists straight. Experts also recommend arm angles greater than 90 degrees for added confort. It's best to keep your mouse at the same height as your keyboard and within easy reach; try not to stretch more than a few inches for it.

Jaslok Hosts A Workshop Which Will Treat Six Patients Coping With Excruciating Pain

THE MIRACLE WORKERS ARE HERE TO EASE SUFFERING

Mumbai: The silence of the ward is broken by the cries of 55-year-old Tehmi Bacha as she tosses and turns in her bed at the south-Mumbai hospital."My back is aching," she moans, her eyes pleading for help. In another room, nine-year-old Sarthik Yadav's mother is trying hard to hush his wails, in vain.

Bacha and Yadav suffer from different ailments but what links them is excruciating pain. It has brought them under one roof at Jaslok Hospital as part of a workshop on pain management that promises to bring them some cheer. A group of specialists from New York-Presbyterian Hospital have arrived here to work alongside desi experts to mitigate the condition of these patients. A little-known branch of medicine, pain management sees doctors, usually anaesthesiologists, work towards alleviating the suffering associated with ailments ranging from migraines and muscle spasms to severe backaches and chronic cancer.

The duo is among six patients seen to be suffering the highest degree of pain, and thus chosen to benefit from this initiative on pain management. They will undergo the latest pain-relief surgeries during the workshop on Sunday. Procedures, many of which otherwise cost a bomb, will be performed free of cost.

Bacha, a mother of three, has been tormented by backaches for the past decade. Three surgeries later, the Dhobi Talao resident still cringes with pain. With painkillers and normal theapies such as nerve blocks failing to ease the neuropathic pain, she's now been chosen to undergo a spinal stimulation procedure, which would normally cost Rs 1.5 to Rs 2 lakhs.

"Chronic pain affects not just the patient, but his family and work life. Pain management recognises pain as a disease in itself and aims to give holistic relief," said interventional pain specialist at Jaslok, Dr Preeti Doshi, who is a participant at the workshop. But awareness about pain relief is only now catching on here, unlike the west where pain relief is routine practice. As Dr Sudhir Dhawan from New York Presbyterian Hospital Points out, "Patients there routinely come to clinics an ddemad pain relief. It is estimated that 40 million people in the US suffer from varying form of pain."

Pain relief may range from popping routine painkillers to low-cost Botox shots or acupuncture therapy for myofacial to more expensive options like radiofrequency or spine surgeries. Usually, patients are recommended highend procedures like the intrathecal drug delivery or implantable pump when routine therapies fail. Yadhav who suffers from spascticity will receive such cutting-edge treatment. A pump loaded with pain-relieving drugs will be placed under his skin to periodically shoot off drug doses to his spine.

THE FINAL FRONTIER

WHAT IS PAIN MANAGEMENT?

A branch of medicine, usually anaesthesiology, which helps patients relieve their pain with the help of medicines, treatments and surgeries:

WHEN SHOULD YOU SEE A PAIN SPECIALIST?

If unbearable pain persists for over three months. It may not be continuous but if it hampers your quality of life, it could do with treatment.

COMMONLY USED PAIN TREATMENTS INCLUDE:

ADVANCED BUT EXPENSIVE PAIN THERAPIES

SPINAL PUMPS

It is a battery-operated pump which contains pain-relieving drugs and is implanted under the patient's skin in the abdomen. The drug is then delivered directly to the area around the spinal cord.

PAIN PACEMAKER

Involves neurostimulation of the spinal cord or a peripheral nerve by means of electrical impulses. A thin lead wire connected to an implanted battery sends out these impulses which then block the transmission of pain messages from the affected part to the brain.

RADIOFREQUENCY

This method uses alternating currents to produce a degree of heat which is then directed to the pain-carrying sensory nerve through fluoroscopy, thus reducing the pain in the affected region.

Awareness on pain relief remains poor

Mumbai: He was a doctor who endured unbearable back pain for months while he went around consulting several colleagues, from orthopaedic surgeons to neurologists, before finally stopping by at one of the city's many pain clinics for help. His prolonged tryst with pain perfectly highlights the lack of awareness about the existence of pain management even in the medical world.

Earlier dismissed as a symptom for other worrying diseases, chronic pain and its treatment has now emerged as a focus area in itself."Pain medicine has certainly evolved a lot in the city, over the years', says interventional pain specialist Dr. Lakshmi Vaz.

Several city hospital now boast of inhouse pain clinics, where the sole emphasis is on relieving patients of their pain. Cancer hub Tata Hospital has its own pain clinic and so do hospitals like Breach Candy, Bombay Hospital in south Mumbai, Hinduja and SL Raheja in Mahim and Wockhardt in suburban Mulund.

So how do we compare with the West? We still have a long way to go, feel experts. "People often don't seek help, till their quality of life is toally impaired even though there are simple, cost-effective therapies available today, which can offer tremedous relief," says Dr Preeti Doshi of Jaslok hospital.

Another expert points out how pain management is often not understood as an area of specialisation. People mistakenly equate pain specialists with faith healers or those offering miracle cures. Theyare, however, trained physicians, mostly anaesthesiologists, with further exclusive training in pain management.

A specialist who didn't wish to be named pointed out that awareness about pain medicine is low among doctors themselves. "If doctors see patients suffering from unbearable pain, they should be directing them to pain clinics,"he said.

Interactions like the ongoing two-day workshop at Jaslok help spread the word. The meeting will see over 150 doctors from various specialities come together, share the latest in pain relief technologies, and comprehensively study the discipline.

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