Tag Archives: wellness

Nidhi Kirpal Jayadevan practicing Yoga.

My Yoga Toolkit To Ease Anxiety

Yoga has always afforded me a sort of mental vacation that helps recenter my focus and energy. It probably sounds a bit esoteric. But let me explain. I find the routine of a few sun salutations, twists, an inversion, the quiet heaviness of shavasana, and some full belly “Oms” revitalizing. After which I breathe deeply with renewed energy, ready to take on and make the most of the at times, challenge-filled fluidity of working from home and remote school, for instance.  

More recently during this anxiety-inducing pandemic, as I worry about our family’s safety in India or read about the ever-spiking cases and crumbling health care system there, my intermittent and improvised yoga practice allows me to calm my nerves and think more positively. I hope for a happy day when we are able to travel to India with our two boys, so they may be able to see their grandparents, aunts, uncles, and cousins, in-person, and I, my folks.

I am by no means a certified yoga instructor – merely a yoga enthusiast who has turned to this ancient Indian practice every now and then at various stages of my life for over two decades now, reaping its wonderful benefits. Every time I surrender to my mat, I rise in a strange mind-body-soul harmony, gently yet firmly, reminding me ‘to just be’. To accept, be grateful, make the most of ‘now’, mindfully and intentionally going about my day.

While I am cognizant that everyone has their go-to activity or means to de-stress and relax, like listening to music, running, taking a short nap, or reading, yoga is mine. The reason I was drawn to it is because it made me pause and slow down my pace of life and mind. I also very quickly realized that yoga doesn’t have to be complicated or enigmatic. It doesn’t need much equipment, space, or time. It’s easy and beneficial. I can do it whenever I want and for as long as I want (or can). 

So, over the years, I have devised my own ‘yoga toolkit’. It has helped me mindfully navigate the curveballs at work and as a full-time parent. And it continues to assist me today, as I, like millions of others navigate this global pandemic, making sense of it, praying for a better tomorrow.

To stay calm, centered, rational, and in control, I often resort to the following yoga tools. I don’t necessarily follow these sequentially or attempt to go through each of them. I simply do what I can.

Breathe deeply for that much-needed clarity.

We breathe all the time. Why not make it conscious and intentional? It’s cathartic and effortless. The two things we all value, especially these days. Focusing on my breath for a few minutes magically helps me hit that reset button. And we all know, taking a pause can help us rationally re-evaluate a variety of situations – personal and/or professional.

When under stress, do the downward dog.

You may end up doing it a LOT. It’s no secret that our current reality possibly fills the most formerly self-assured people with doubts: small, big, and huge. Often! But when has a bit of stretching, sculpting, toning, and blood flowing to the brain been a bad thing? It not only helps us all take that much-needed pause but forces us to see the world from an upside-down (different?) perspective.

Create space between the ears and shoulders.

This is something we don’t even think about but can do all the time – while sitting, standing, and lying down. Just pull your shoulders down and straighten your neck to create some space between the tips of your ears and the tops of your shoulders. Not only check your posture but also feel that stress release. You’ll likely feel taller, more in control, and will look graceful too. Tip – you can add to it by tucking in your tummy, working those abs. But don’t forget to breathe!

Relax in child’s pose.

Again, a little bit of flexibility and stress/ blood pressure reduction can’t be all bad! A time to rest, and reset, and secretly build flexibility and work those abs.

Massage the top of your head and the nape of your neck.

Isn’t that what they did when physically going for a massage was a possibility? Granted, it’s not the same as getting that divine massage, but it’s certainly something. Creating some scalp blood circulation apparently helps with hair growth too.  

Lie in Shavasana for that divine sleep and mental reset.

A few minutes of Shavasana prior to a nap or hitting the sack for the night helps me breathe deeply and relax, setting me up for some quality rest time. Tip – a scalp massage with some meditation music prior only makes the sleep deeper and more restful.  

In summary

Feel free to harness the power of this ‘Yoga toolkit’ alone or with kid(s), your spouse/ partner. It’s relatively simple and doesn’t entail much. Best of all, it’s iterative. Pick what you feel like. Add to it if you want to. If a backbend or headstand is part of your practice, go for it. If you want to just lay down, massage your head, and tune out breathing deeply in Shavasana, do it! It’s also indulgent. Remember to work with your energy levels and time commitments. Don’t endeavor for that perfect pose. These tools can be hugely gratifying, relaxing, and mentally and physically centering. Something we all crave and can benefit from.  

Here’s wishing us all the very best, as we surge forward with positivity, gratitude, and mindful intention.

Om Shanti, Shanti, Shanti, Om…….

Nidhi Kirpal Jayadevan is an avid reader and a yoga enthusiast. Her pre-kids life was dedicated to the complex field of Communication Sciences. After choosing to be a full-time mother, reading and playing with her high-energy boys has been a fascinating journey. It has (re)kindled in her a sense of wonder in all things small. She constantly sees the world through little eyes, applying simple learnings to deepen life’s meaning for herself and her family.

 

Why Indian Immigrants Are Facing a Unique Wellness Challenge

As America celebrates the loosening of the mask mandate, on the other side of the globe, there is a contrasting scene unfolding, complete with doom and gloom. Since April 2021, India has been battling the second wave of Coronavirus. Mass funerals, new variant reports, vaccine shortage, and an overwhelmed healthcare infrastructure are the new themes in the Indian media outlets. 

Whatsapp is abuzz with concerned messages from loved ones as well as news of losses and hospitalizations. Social media is brimming with not only political whodunnit analyses but also generous fundraising efforts.

Stories abound on how nepotism and bribery came to the forefront, especially when procuring a hospital bed. While in the same thread, we hear heart-tugging stories of kindness and sacrifices, where the human spirit has triumphed.

If you are an Indian immigrant living in the United States with family back home, then you are likely living the nightmare you have always dreaded – that late-night call. 

The fear that you are unable to be there for your family during their darkest hour.

The survivor’s guilt has possibly reached its peak within you. 

Neeta Jain worries in the US about her family in India (Image provided by Author)
Neeta Jain worries in the US about her family in India (Image provided by Author)

 The visa limitations due to outdated immigration policies and the newly imposed travel restrictions further exacerbate the situation for some immigrant families.

Indian immigrants are experiencing high levels of anxiety right now. Some are grieving, some are feeling helpless or guilty. The impact these emotions could have on their health and wellness is unimaginable. Especially given the always-on work culture in corporate America. 

As Indian immigrants continue to power through Zoom meetings, work deadlines, and deliverables, there is little empathy shown in most Corporate American settings. There are not enough conversations about the toll this second wave is taking on the wellness of Indian Immigrants in the United States.

The anxiety attacks. 

The sleepless nights.

The emotional eating disorders.

The survivor’s guilt, which is probably the hardest to reconcile.

While we continue to hope for the situation in India to improve and demand immigration policy reforms, here are five things we can do to take charge of our well being right away:

PLAN A FAMILY ACTIVITY: While our families are in lockdown in India, create a simple daily or weekly activity together, where you and a family member are bonding. Here is an example for inspiration. Bring out a new book and write down recipes from your mother, father, grandmother, or sibling. And even attempt cooking it! Food is love and food is nostalgia, and hence a powerful medium to stay connected. Also, most family recipes are hearsay and rarely documented in a structured format. So this will be a prized possession for years to come!

FOCUS on BASICS: Sleep & hydration. During extreme moments of anxiety, insomnia could surface for some of us and sleep quality and quantity may be negatively impacted. In addition, watching our water intake could take a back seat and we could be hydrating ourselves poorly. When you are going through a rough phase, it is best to keep things simple and focus on basics i.e. Sleep and Hydration. Moreover given these are emotional times, our food cravings could also come back with a vengeance. Maintaining good sleep hygiene and staying hydrated will help with those food cravings too.

GET GROUNDED IN NATURE: With the weather warming up in the northern hemisphere, getting out in the sun and soaking in the abundance that nature offers, will help destress and calm those nerves. Also, feel empowered to take a social media break, a news break, or a complete digital detox to reconnect with nature in any way that feels most aligned with you.

GRATITUDE JOURNAL: It has been hard to stay positive for even the most optimistic person in the room. And hearing for the nth time “Stay positive” or writing affirmations may neither be effective nor helpful right now. But having a gratitude practice, especially in the form of a journal can be transformational. When you bring paper and pen together, the brain is able to process the emotions a bit better, especially those of anxiety and grief. Write 3 things every morning that you are grateful for before you get immersed in the daily grind (Note: this can be the littlest thing!).

FACE THE GUILT: Lastly and likely the most challenging, as facing the Survivor’s guilt requires a great deal of vulnerability. Becoming aware and acknowledging this guilt, which may be wrecking those who have had losses amongst their families or friends is hard. Moreover, there is still a fair bit of stigma around getting help from a therapist or a counselor in the South Asian community. However, try and step beyond that stigma if you can and get help from a licensed practitioner to process this guilt.

Neeta Jain is a health coach and the founder of Her Shakti, a wellness company that helps immigrant women transform into their healthiest, strongest selves. Go from overwhelmed busy bee to nourished goddess with her free tips.

 

Bacterial strains in the guts of humans and chimpanzees diverged and began to evolve separately 5 million years ago and 15 million years ago in humans and gorillas. Humans and apes evolved into a new specie at about the same time. A mutually beneficial relationship between gut bacteria and animal hosts may contribute to the formation of a new species (Credit: Darryl Leja, National Human Genome Research Institute, National Institutes of Health)

A Microbe Connection: the Good, the Bad, & the Necessary

Engage – Discussions on active involvement in personal health and global wellness.

This two-part series highlights the emerging relevance of our microbiome in human health. In this first part, we discuss the establishment of the microbiome from infancy to adulthood and the highly responsive nature of these trillions of cells to the environment. The geographical diversity of microbiomes in various cultures, and the mandatory nature of the acquired living situations of immigrants are of immediate relevance. The second part, which will be published in June, will focus on the effects of the microbiome on human health and disease. 

Traditionally, our interaction with microbes has been focused on how deleterious they can be. Viruses, bacteria, and other microorganisms have been responsible for several contagious diseases, including typhoid, cholera, mumps, smallpox, polio, malaria to name a few, some of which we take credit for controlling with medicines and vaccines. 

However, emerging knowledge of the human microbiome is informing us that an entire army of microbes including bacteria, fungi, viruses, and other fauna coexist in symbiotic (meaning mutually beneficial) and commensal (meaning neutral coexistence) relationships with our bodies, and are beneficial in that they play an important role in maintaining homeostasis and optimal functioning of the body. Comprising of at least an equal number of cells as the human body itself, the microbiome constitutes what is termed a newly discovered organ in our bodies – one that is dynamic, diffuse, and very different from what we conventionally think of as a discrete human organ (liver, heart, brain or lung). 

Microbiota colonize the entire surface of our bodies and the specific niches within. Several studies have tried to describe the species that are found in various locations, and these descriptive studies paved the way to deeper ones aimed at understanding how they are established, maintained, and function. We are learning that the establishment of these populations occurs from the earliest days of one’s existence, and their effective maintenance throughout one’s life is as important as having a healthy heart. 

Infants are exposed to the maternal microbiome during the process of birth, and differences in the complexity of their microbiomes are seen in normal birthing situations versus cesarean sections. During their early days out of the womb, colonization of microbes within their bodies and also on their skin is associated with good overall health, in the immediate and long term. Taken a step further, this intergenerational transmission can be extended to envision a co-evolution of humans with their microbiomes as a discrete ecological unit. Members of a family, or people who occupy the same household, are known to share similarities in their associated microbiomes. A linear study of 6 large Indian joint families also indicated changes in microbiome with age.

Further afield, one can well imagine that geographical and cultural differences will lead to variations in associated microbiomes. Most of us are aware that microbes exist in the intestines and mouth, and there is an immediate and important influence of diet on these populations. While different species of bacteria have been found to be the dominant population in different geographies, one study reported that the African diet was associated with the most gut microbial diversity. In general, a lack of microbial diversity is associated with urbanization and developed countries, and some factors thought to be related to this outcome are increased consumption of processed foods, increased use of antibiotics, reduced sleep, and loss of natural habitat. This lack of microbiome diversity is directly related to human disease. We are learning that diet can lead to changes in the microbiome in a matter of hours, not days, and can regulate the secretions of the bacteria in addition to the populations of the bacteria themselves. 

South Asian diet contributing to gut microbiomes.
South Asian diet contributing to gut microbiomes.

Even within the same geography, different lifestyles and ethnic groups showed differing gut microbiomes. In a cross-sectional study in Malaysia, the gut microbiome of Malaysians of Malay, Chinese, Indian and Jakan descent varied principally by ethnicity of the subjects, who were of the same socioeconomic status and geographic location. Perhaps more relevant to this discussion, studies conducted to compare gut microbiomes in rural and urban groups in Thailand and India suggested that urban populations have reduced numbers of bacteria that can produce beneficial anti-inflammatory molecules. In most cases, researchers associate these reductions and changes in gut microbial diversity with dietary preferences of urban and rural settings- urbanites tending to include less natural foods, vegetables, and whole-grain in their diets. 

Pioneering studies in immigrant communities were conducted in Amsterdam and Minnesota. The Amsterdam study analyzed six immigrant ethnic groups including Moroccan, Turkish, and South Asian Surinamese, and as with the Malaysian (non-immigrant) study the gut microbiome varied principally by ethnicity. Southeast Asian immigrants from Laos, Vietnam, Myanmar, and Thailand were sampled in Minnesota, and it appeared that their gut microbiome assimilated to their new homeland. It took about a decade for this group to substantially transition to the US-associated gut bacterial profile. Although diet would play a big role in this, it is thought that other lifestyle changes, medicines including antibiotics, and other as yet unexplored variables may play a role in this remarkable change. An unfortunate correlation among these immigrant populations is the onset of obesity and diabetes. 

Our understanding of this complex and dynamic organ continues to develop, in tandem with our understanding of its involvement in human health. These aspects will be discussed further in the second installment of this article. 

L. Iyengar has lived and worked in India and the USA. A scientist by training, she enjoys experiencing diverse cultures and ideas and writing. Her short story will be included in an anthology showcasing a group of international women writers, to be published in 2021 by The Nasiona. She can be found on Twitter at @l_iyengar. www.liyengar.com

Featured image license here.

 

Brain with symptoms of Dementia (Image by Natasha Connell from Unsplash)

Are Amma’s Memory Lapses Normal?

Sukham Blog – A monthly column focused on South Asian health and wellbeing.

Amma is fiercely independent. “I’ll take care of myself as long as I can,” she insists. Living by herself, she manages all her needs. Not being a burden on others is a matter of pride for her, and we, her children, are really proud of her. A couple of months ago, however, we began to notice changes that made us uneasy. On a shopping trip one day, she couldn’t recollect why she’d come after we got to the store. Last month, after dinner at her home, she wondered aloud if she had taken her medicines, although we had seen her do so just fifteen minutes earlier. She asked me over a few days ago to help move some boxes but didn’t remember that when I got there. Were her memory lapses normal? She seemed just fine otherwise! 

We all forget things.  I thought I left the car keys right here, but I don’t see them now.  Did I lock the front door?  Did I turn off the stove?  It was really embarrassing – not remembering her name when she came up to say hello at the party last night. Memory lapses are commonplace, and we generally brush them off casually – even jokingly sometimes, saying “I had a senior moment,” implying that such behavior is associated with aging. However, it’s really important we learn to recognize when such incidents are not normal memory lapses, but signs of something more serious – signs of dementia.

Forgetfulness is often caused by normal, age-related memory loss. It can also result from lack of sleep, or be induced by stress or depression, even in younger people.  When it is part of a larger pattern, however, it could be a warning sign of dementia; an umbrella term that describes a collection of symptoms including changes in thinking, memory, or other cognitive functions. Dementia can be caused by a number of disorders that affect the brain such as Alzheimer’s disease, vascular dementia, or Lewy Body disease – to name a few. People with dementia have significantly impaired intellectual functioning that interferes with normal activities and relationships.   

The Alzheimer’s Association provides a very useful guide to recognizing the 10 early signs or symptoms of dementia:

  1. Memory loss that disrupts daily life.
  2. Challenges in planning or solving problems.         
  3. Difficulty completing familiar tasks.
  4. Confusion with time or place.
  5. Trouble understanding visual images and spatial relationships.
  6. New problems with words in speaking or writing.
  7. Misplacing things and losing the ability to retrace steps.
  8. Decreased or poor judgment.
  9. Withdrawal from work or social activities.
  10. Changes in mood and personality.

Here are some examples of such behavior:  Trouble balancing a checkbook. Forgetting dates and events. Repeating the same questions over again. Trouble following a recipe they’ve used for years. Difficulty concentrating or taking longer to do things than before. Remembering directions to a place they have visited often. Forgetting where they are or how they got there. Inability to keep up with a group conversation. Losing things and/or accusing others of stealing. Giving up hobbies and other regular activities. Losing interest in social activity. Experiencing sudden mood swings, or easily getting fearful or anxious. If you begin to see repeated patterns of these kinds of behavior in yourself, a family member, or a friend, do not ignore them!

A slight, but noticeable and measurable decline in cognitive abilities, including memory and thinking skills is called mild cognitive impairment or MCI. MCI usually does not significantly affect a person’s ability to carry out his or her daily activities, although you can usually spot its symptoms if you know what you are looking for.  An early diagnosis of MCI and identification of possible causes – such as the side effects of medication – is very important. People with MCI (this includes about 15-20% of seniors over 65) are more likely to develop Alzheimer’s or other dementia-related diseases. Some in this population remain stable or get back to normal cognition if the underlying cause can be removed. In many cases, however, MCI is an early stage in the onset of Alzheimer’s or other dementia-related diseases. 

Alzheimer’s disease is one of several terminal, progressive brain disorders with no known cause or cure.  The Food and Drug Administration (FDA) has approved a few drugs for the treatment of its symptoms. However, memory, cognitive functions, and the ability to care for oneself continue to decline, until the individual has little awareness of his or her surroundings and requires round-the-clock supervision and care, including help with personal care and all other activities of daily living.

It’s therefore even more important to contact a doctor as early as possible for a thorough examination if a parent or other family member shows signs of cognitive impairment or dementia. A specialist in cognitive function can conduct a thorough examination and evaluation that includes physical exams, diagnostic imaging, and neuropsychological testing, to determine whether these are symptoms of normal aging, of MCI that is potentially reversible, or of a condition that will eventually progress to dementia.  There is no single definitive test; neurologists, geriatricians, and psychiatrists typically use a combination of tests and assessments in their diagnosis.

The statistics on dementia and Alzheimer’s disease are grim. Around 50 million people live worldwide today with dementia-related disorders. Alzheimer’s Association estimates that six million Americans currently live with Alzheimer’s, increasing to 13 million by 2050.  Dementia and Alzheimer’s related deaths increased by 16% during the current COVID pandemic.  The Centers for Disease Control and Prevention ranks it the sixth leading cause of death in the United States; it kills more than breast and prostate cancers combined. Between 2000 and 2019, deaths from heart disease decreased by 7.3%, while Alzheimer’s related deaths increased by 145%. 15% of the population 70 and older has dementia. 1 in 3 seniors dies with Alzheimer’s or another dementia. Dementias will cost the US an estimated $355 billion this year, not accounting for more than 11 million people who provide unpaid care for family members or friends. 

This is a national and worldwide crisis, and we need to learn to recognize potential signs of dementia and act early if we see them.  We also need to learn how to deal with dementia.  A subsequent article will discuss what to do if Amma receives a dementia diagnosis.

Mukund Acharya is a regular columnist for India Currents. He is also President and a co-founder of Sukham, an all-volunteer non-profit organization in the Bay Area that advocates for healthy aging within the South Asian community. Sukham provides curated information and resources on health and well-being, aging, and life’s transitions, including serious illness, palliative and hospice care, death, and bereavement. Contact the author at sukhaminfo@gmail.com

 

Mother and Baby

The Lori, Jola, Angai Geet Keep Us Awake

A lullaby is as ancient as the hills. It connects a mother to the child, much like an umbilical cord, nurturing both. It brings about “an exchange of souls” as suggested by Bayartai Genden, a propounder of the lullaby. Although called a cradle song since its start, it may prove helpful even in serious adult illnesses and in hospice as discovered by modern scientists. Upon first hearing the sound of the mother, the baby gets hooked on to her. But when does the baby even start hearing? That is a fascinating story to unravel.

Embryological Roots of Hearing

At about 18 weeks of life in the womb, the baby perceives the first sound of the beating of her mom’s heart, her breathing sounds, her intestinal gurgling, and the stream of blood passing through her umbilical cord. No wonder the baby, later on, enjoys the sound of a stream or river, which is her deja vu experience! In the third trimester of pregnancy, the baby specifically recognizes her mother’s voice as evidenced by her heart rate increasing when the mother is talking outside. The baby, however, has to hear her mom’s voice through a fluid medium and has to develop a correlation upon her birth that she heard the same voice then and now! 

A Lullaby Is More Than Just a Tune For a Baby  

Scientific experiments show that the baby prefers hearing her mother’s own voice singing a lullaby rather than somebody else’s. The baby also prefers the subject matter of the lullaby to be infant-directed rather than non-infant-directed! Thus starts the story of “me and mine!” The topic of the lullaby may inevitably get modified as the mother employs it to express her fears, hopes, and prayers. 

I learned in my school a lullaby attributed to Shivaji’s mother, Jijibai, who prepared her son to wage and win a war when he grew up. “Sleep now, but fight later,” she sang. This correlates well with the story of Abhimanyu in Mahabharat wherein he learns the art of war while in the uterus.

An Obstetrical Clinic in California teaches pregnant mothers to talk to their baby in the womb. I also learned a lullaby sung by the mother of a child laborer in the textile industry. She lamented waking up her child from a deep sleep of early morning to report to his daily hard work. A Syrian mother changed her soothing lullaby to a fear-stricken one when she was forced to migrate to Turkey to escape the brutal conditions in Syria. Highly toxic polluted air in Ulaanbaatar, Mongolia prompted a mother to shift her children to safer surroundings and sing a nostalgic song about how her beautiful country had so drastically deteriorated!

Thus a lullaby may often unfold an ongoing tale of changing conditions.

Lullabies: A Universal Blanket Covering the Vast Universe

Hannah Reyes Morales, from the Philippines, deserves special credit for reawakening our interest in the lullaby. She has reviewed the world history of the lullaby in National Geographic (December 2020) with accompanying eloquent pictures related to the subject. In fact, there is no part of human culture or province that the lullaby has left untouched. It is ancient but alive and needs to be nurtured to be kept alive. Every country from A to “Z”, so to speak, has its own synonym for a lullaby, the core remaining unchanged.

The French call it Berceuse, the Western musicians Lullaments, while a multilingual country like India has many names for it. It is called Lori in Hindi, Jola in Telugu, Thalattu in Tamil, Nanabaya in Odia, Angai Geet in Maharashtrian, Halardu in Gujarati, Ghum-Parani-Gaan in Bangladeshi. Some of our Christmas carols like “Silent Night, Holy Night” could have been a lullaby to baby Jesus. Dating even further back, a Babylonian lullaby about 4000 years old was found inscribed on a clay tablet.

Our Rich Heritage of Hindi Loris

Undoubtedly, there has been an inadequate exploration of the rich treasure of lullabies in multilingual Indian literature and folk songs. Loris of Indian film songs have a significant contribution to that wealth. They have expressed love, pathos, social adversities, abounding hopes, depressing despairs, panoramic nature, spiritual insightfulness, and a vast gamut of a mother’s powerfully emotional feelings. I was disappointed to see that an exhaustive article on the subject as in National Geographic did not make any mention of Indian lullabies. It also is noteworthy that some of the most outstanding lullabies have been written by men, who often distance themselves from the babies in our society. Yes, men too, can connect to this chorus at home and around. I remember many lullabies that my father sang before I slept. 

Modus Operandi of a Lullaby

It is marvelous, mysterious, and miraculous! The baby gets reassured, the mother relieved, and both of them feel ready to sleep at its end. As proposed by Freud, the baby is not afraid of the dark but has isolation fear, while the mother herself also needs some privacy with the baby. As the baby wants to be lulled to sleep (that is why it is called lullaby), the mother also wants to feel the fulfillment of her maternal connection. It is therefore not uncommon to see a mother falling asleep even before the baby. A lullaby supports the spirit, psychology, and resilience in adversity, all of which have a therapeutic value. It is simple, repetitive, rhythmic, and soothing. A father or a sibling can subsequently substitute for the mother, thus widening the base of the bond. A joint presence of both parents at the sleeping time of the baby generates reassuring accountability and dependability in both parents. The baby needs this support to be self-supporting later in life.

Modern Science Extends Applications of the Lullaby Beyond Babies and in Covid-19

Based on the concept that a lullaby has a therapeutic value before sleep, it has been also applied in hospice patients as well as in premature or sick children. Childhood and old age are often placed on comparable rungs of the same ladder of life so a lullaby can bring extra comfort to both, from a state of wakefulness to drowsiness and even death as in hospice patients.

Laura Cirreli, Professor of Developmental Psychology at the University of Toronto who studies the Science of Maternal Song, has reported a decreased level of stress in both mother and baby induced by warm gentle rocking. There is also a lullaby project conducted by Carnegie Hall in New York City. Samuel Mehr, Director of Harvard University’s Music Lab, asked 29,000 participants to listen to 118 variegated songs to evaluate their healing power. “Statistically, people are most consistent in identifying lullabies,” he said. 

During the isolation of children from working mothers as in the covid-19 period, mothers sang their lullabies from hospitals and working stations using zoom to comfort their children sleeping at home. What a wonderful use of technology to transmit continuing love and care to the young ones!

Going back to our own country India, Jagdish Chandra Bose (1858-23) proved the comforting effect of music even on plants. Amar Bose (1929-13), who fathered the wireless passage of sound, substantiates that a lullaby functions exactly on the same principle! The sound of music is ever so sound. We better keep our lullabies awake.

Bhagirath Majmudar, M.D. is an Emeritus Professor of Pathology and Gynecology-Obstetrics at Emory University, Atlanta, Georgia. Additionally, he is a priest, poet, playwright, Sanskrit Visharada, and Jagannath Sanskrit Scholar. He can be contacted at bmajmud1962@gmail.com. 

 

Mind Matters.

Mind Matters: Mental Health in South Asian Americans

A recent article in India West reported that a higher percentage of South Asian Americans, especially between the ages of 15 and 24, had been found to exhibit depressive symptoms and a higher rate of suicide among young South Asian American women compared to the general US population. Likewise, studies have spoken of how South Asian immigrants have high rates of mental health disorders that go unaddressed.

Asian American Connect

Dr. Priyanka Thukral Mahajan
Dr. Priyanka Thukral Mahajan

Other studies have shown that immigrants from South Asia to the USA and their children face numerous mental health challenges.

“This could be on account of acculturation, that is cultural or psychological changes that occur as a result of prolonged first-hand contact between two different belief systems or cultures. Stress predominantly originates from their attempts to incorporate ‘American’ traits in their own culture. This eventually shows up as a cultural conflict. Multiple other factors contribute to this stress, including alienation and separation from their families and loved ones, language barriers preventing true socialization, uncertainty around their immigration status, financial stressors, as well as in certain cases, overt or perceived discrimination, and more generally, barriers to cultural integration,” says Dr. Priyanka Thukral Mahajan, Consultant Psychiatrist, Masina Hospital.

Conflict Concerns

Eventually, this cultural conflict leads to uncertainty around belonging. This is particularly more visible in the workplace. The effects of prolonged acculturation and discrimination result in a wide spectrum of psychological disorders over time. These include depression (primarily due to isolation, financial stress), somatization (i.e., self-interpretation of mental health symptoms as physical symptoms and not seeking help), anxiety (again on account of alienation), substance abuse disorders, especially alcohol.

“Such disorders have a dark underbelly, as they are one of the key reasons for increasing rates of suicides among South Asian immigrants in America. The tragedy is that all the above is neither widely known nor acknowledged. The issue is accentuated further by the challenges associated with seeking help from mental health professionals in the form of psychological counseling. If one gets into the weeds of the issue, one realizes that such immigrants have limited means of confiding their feelings with mental health professionals in the USA, given cultural barriers and differences. It is difficult for professional mental health professionals to understand their feelings and challenges, correlate with their culture and truly empathize with them,” adds Mahajan.

Ethnicity Woes

Dr. Sahiba Sethi
Dr. Sahiba Sethi

South Asian countries have been right in the center of the pandemic conversation throughout. Though the impact for South Asian Americans is even more convoluted. At the height of the pandemic, last year xenophobia gripped multiple countries and this community bore much of the backlash for no fault of their own. The lingering effects continue in a lot of pockets. The impact that it would have had on their mental health would be enormous. 

“Personal stories shared by individuals across the world via my online counseling sessions gave me an insight into the South Asian American community and their fears. The last 14 months, we have seen an increased prevalence of nonpsychotic depression, pre-anxiety, somatic concerns, alcohol-related disorders, and insomnia in general. Parents worried about their children’s safety have given rise to psychological symptoms correlated more with physical complaints of fatigue and pain in older adults. This was directly related to social media use, misinformation, xenophobia, and social distancing. The resulting isolation made a lot of people see the bad rather than the good in a community. Frontline workers reported guilt, stigma, anxiety, and poor sleep quality, which were related to the lack of availability of adequate personal protective equipment, increased workload, and discrimination,” says Sahiba Sethi, Counseling Psychologist, Ummeed Healing.

Apps as a Tool

Dr. Nabhit Kapur
Dr. Nabhit Kapur

Apps are just a click away, so are easy to access. 

“And some may already be socially isolated and experiencing loneliness which can worsen mental health. COVID-19 itself can lead to neurological and mental complications, such as delirium, agitation, and stroke,” says Nabhit Kapur, Founder President of PeacfulMind Foundation.

Apps help people connect in their native languages to a therapist who understands their culture and can empathize with their situation. Some of these apps are powered in the background by Artificial Intelligence.

“These apps help such immigrant patients deal with their mental health issues in a much better way. Their biggest advantage is the patient’s perceived lack of being judged by a third person, resulting in lower stigma towards using them as against meeting a mental health professional in person. This stigma is a huge barrier especially in the South Asian community given the cultural background. A key issue with such apps, however, is in certain instances the patients may not feel truly connected with the device, which can result in a decline in their usage over time. A recently launched app for this purpose is SAMHIN (South Asian Mental Health Initiative and Network). Another one that has been in existence for a longer duration is SASMHA (South Asian Sexual and Mental Alliance). These apps can help connect people who need psychological counseling, with various platforms, to seek support and find mental peace,” says Mahajan.

COVID Angle

Dr. Prakriti
Dr. Prakriti Poddar

Statistics reveal that only 23% of non-Americans in the USA seek mental health, against the 40% of Americans born in the USA. Patients from such communities find it arduous to find a mental health professional from their own community, who can understand their situation and truly support them. Covid-19 pandemic has further worsened the above dynamic. As is very well known, the sheer incidence of mental health issues has gone up significantly through this pandemic due to heightened financial insecurity, lack of social contact. For the immigrants, seeking medical help in these times has become even more challenging.

Prakriti Poddar, Global Head for Mental Health at Round Glass, Managing Trustee Poddar Foundation says, “a 2018 study found out that stress related to acculturation, trauma, and discrimination has been linked with depression, anxiety and substance abuse among South Asian Americans. Also, the COVID-19 pandemic has affected South Asian American communities by increasing stress and anxiety levels in terms of health concerns and issues such as employment and housing.  Due to the uptick in violence and hate against the South Asian American community, racism has also severely impacted the mental health of the community.”

Breaking Taboos

Dr. Aparna Methil
Dr. Aparna Methil

In India, it is an uphill task to change perceptions related to mental health predominantly due to the stigma associated with it. The challenge lies in creating the right kind of awareness about mental health problems and encouraging people to seek the right kind of help from mental health professionals.

“Mental health crisis can be attributed to the outbreak of Covid-19 and resultant loneliness, isolation, fear of loss of life, financial insecurity, job cuts, salary cuts, and overall economic uncertainty. The common mental health issues associated with the COVID-19 pandemic are stress, anxiety, depressive symptoms, insomnia, denial, anger, and fear reported among Indians. Stress, anxiety, and depression have been closely related with the COVID-19 pandemic,” says Dr. Aparna Methil, Vice-President, Operations, Mpower. Mental health issues faced by South Asian immigrants in the USA are immense and one of the ways to tackle the challenge is to take the help of technology. After all wellness in a click matters the most.

Mental Health App List

Bindu Gopal Rao is a freelance writer and photographer from Bangalore who likes taking the offbeat path when traveling. Birding and environment are her favorites and she documents her work on www.bindugopalrao.com.

 

Two Fallouts of Working Behind a Screen

I have been working from home since the middle of 2020, ever since the pandemic struck. There are two fallouts that I have experienced from that.

One was unexpected.

My finger rings had been acquired over the years and were designed to fit well either on the fingers of my left or right hand. All my life, up until this point, the fingers of my right hand were thicker than the respective fingers of my left hand, which made perfect sense as my right hand is the dominant one. Now, to my surprise, I was able to wear rings on my right hand that refused to slide beyond the knuckle of my left hand.

Curious! After some due consideration, I attributed it to the increased computer workload and typing. My style of typing involves a greater reliance on my left-hand and these fingers get a good workout. On the other hand (no pun intended), my right-hand moves around, maneuvers the mouse, hits delete, space, and other non-word keys – a moderate all-around workout. I consider the ring conundrum solved. 

The second fallout was less amusing. My eyes started reminding me, in no uncertain terms, that something was different and I needed to pay attention. Severe eye strain coupled with headaches occurred with increasing regularity, becoming altogether too frequent, compromising work, recreation, and life itself.

I made an appointment with my local eye-care provider as my eyes clamored for attention. My optometrist handed me a card with printed material of various sizes on it and asked me to read it. As I read the card, I couldn’t help but smile. Apparently, I learned as I read, Galileo had affirmed in his 17th-century analysis of the senses that sight was the ’most excellent and noble of the senses.’ Neither Galileo nor my optometrist was going to get any argument from me on that point. 

Working from home definitely has its perks. It saves the environment from fossil fuel exhaust, deletes the interminable boredom of getting stuck on the freeway, and drastically reduces the infections one tracks back home from work. However, it also allows one to get sucked into a routine of being wedded to the computer for endless stretches of time. Ironically, even what counts as relaxation- reading the news, or playing a game- is channeled through a screen. This lifestyle leads to an escalating increase in screen time.

Working in an office environment involves movement that we take for granted. We attend face-to-face meetings seated around a table, converse with colleagues and friends, walk to the cafeteria or a seminar, and commute to work. Setting up an office at home inherently gives priority to a quiet space within the home environment, where the computer screen is the focal point. In the present pandemic, meetings, conferences, seminars, even happy hours are conducted through the screen, not to mention the actual work. Several of us are sucked in this routine for at least five days a week, and those windows to our soul need our conscious protection. 

An eye.

This dependence on digital technology has led to a condition that has been dubbed digital eye strain (DES). The most obvious symptom is headache, especially around the back of the eyes. Other indicators include strained eye muscles, neck and shoulder pain, irritated eyes and blurred vision, light sensitivity, along with an increasing dependence on prescription eyeglasses.

Eye strain is a result of continuously forcing the eyes to focus on a relatively close and bright screen. Constant focus on an object that is at a close distance strains the eye muscles. Secondly, uninterrupted focus on a bright object also causes strain.

A simple fix to the distance issue is to use what is commonly called the 20-20-20 rule. Focus your eyes on a distant object about 20 feet away, for 20 seconds, at 20-minute intervals. Focusing on a distant object relaxes the eye muscles, and it takes 20 seconds for the muscles to relax. Next, maintain the brightness of the screen at approximately the level of the ambient light. Although there is mention that the blue light wavelengths emanating from screens damage the retina, a sensitive nervous layer at the back of the eyes, there is not enough evidence to confirm this. Nevertheless, protecting the eyes with lenses designed for computer work is not a bad idea. Also keeping the monitor about 1.5 to 2 feet away from your face will help mitigate both these contributing factors. 

Moderation is the key. It is important to take frequent breaks away from the workstation, stay hydrated, use artificial tears if the eyes feel dry, and find a comfortable posture and office desk/chair set up to enable less strain on the body while your mind is working at warp speed. 

Your eyes need to last you for your lifetime. Providing them with the best framework to keep up their essential work, and cope with the prevalent times, seems prudent at the very least. 

L. Iyengar has lived and worked in India and the USA. A scientist by training, she enjoys experiencing diverse cultures, ideas, and writing. Her short story will be included in an anthology showcasing a group of international women writers, to be published in 2021 by The Nasiona. She can be found on Twitter at @l_iyengar. 

 

Melting Glacier (Image by Melissa Bradley at Unsplash)

Climate Change and…the Loss of Sukham?

Sukham Blog – A monthly column focused on South Asian health and wellbeing.

When I see or hear the words Climate Change, I conjure up mental images of global warming, rising temperatures, melting ice caps, rising ocean levels, increasing CO2 and methane emissions, more frequent extreme weather events such as flooding, drought, and wildfires, and our planet Earth rapidly becoming less habitable for present and future generations.  My mind does not turn immediately to the ongoing impact on human health, and the decreased quality of life that brings for people, something that is also happening today. Climate change is a big driver of poorer health and circumstance, resulting in hardship and loss of contentment – loss of Sukham for millions of our fellow human beings. Climate change and Sukham are intertwined.

We – the general public – need to be acutely aware of all the ways climate change can affect our health. We need to learn how we as individuals, as communities and as nations can respond.  Climate change as a current and future public-health crisis is not getting the attention it desperately needs. 

We often hear about the effects of air pollution on our respiratory system and eyes, and the need to take precautions, especially for those with asthma and other respiratory ailments. Plants produce pollen for longer periods in warmer conditions. Grass pollen and plant growth increase with increased carbon dioxide concentrations, causing longer and more intense allergy seasons. For some individuals, including this author, the allergy season now stretches from early spring into late fall.  In her 2019 Scientific American article, Emily Holden describes the associated worsening of respiratory illnesses and heart and lung disease. There are several other health impacts that we will discuss. However, climate change is not just making people sicker. Dr. Renee Salas, an Emergency Medical Physician at Massachusetts General Hospital and Harvard Medical School leads a working group of over 70 U.S. organizations, institutions, and centers working at the nexus of climate change and health. “The climate crisis is impacting not only health for our patients but the way we deliver care and our ability to do our jobs. And that’s happening today,” she says. For example, changing heat patterns affect the way in which prescription medicines work. Climate events impact the availability of critical medical supplies in hospitals. Disruption of electric power supply to homes, hospitals, and clinics puts the lives of patients at risk.  Evidence is mounting for decreased survival of cancer patients due to treatment disruption caused by extreme weather events.  These are just some of the ways the health care we receive is being impacted.

Climate Change CDC infographic
Climate Change Infographic (Image by the CDC)

The accompanying infographic from the National Center for Environmental Health at the US Centers for Disease Control (CDC) provides an easy-to-understand overview of these health impacts of climate change.   Coupled with other natural and human-made health stressors, it influences human health and the spread of disease in a number of ways.  Physical, biological and ecological systems are impacted. The four primary manifestations of climate change are portrayed in the center of the graphic. Together, these manifestations drive eight primary responses: extreme heat, severe weather, air pollution, water quality, increasing allergens, environmental degradation, impacts on food and water supply, and changes in the ecology of vectors – agents such as mosquitoes, ticks, fleas, parasites and microbes, which carry and transmit infectious pathogens into other living organisms, thereby spreading a variety of diseases.  These eight primary responses in turn result in heat-related illnesses, asthma and respiratory disease, cardiovascular disease, mental health impacts, forced migration, civil conflict, malnutrition, and a wide range of diseases ranging from diarrhea and cholera to malaria, dengue, chikungunya, and the West Nile virus. The complete list is frightening. 

The CDC points out that some of the existing health threats will intensify and new, as yet unknown health threats will emerge.  Some of these impacts are global, others are national and/or regional.  Children are disproportionately impacted by some of the health issues.  Health inequity puts parts of the population at higher risk, based on their age, economic status, geographic location, and access to resources. The U.S. Global Change Research Program published a detailed scientific assessment describing how climate change is already affecting humans, and what we may expect in the years to come. This is an excellent resource for those who want a deep dive on this subject.

What is being done about this public health crisis?  The US National Academy of Medicine (NAM) is leading the way in collaboration with the National Academies of Sciences, Engineering, and Medicine (NASEM).  They are developing an initiative to comprehensively assess the health risks of climate change and develop strategies to address both drivers and impacts.  In October 2020, they announced the NAM Grand Challenge on Human Health and Climate Change.  This is a multi-year strategic initiative to develop public-private partnerships with three objectives:  develop a comprehensive and long-term roadmap for transforming systems — such as health care, transportation, infrastructure, or energy – which impact or are impacted by climate change, with a focus on human health, well-being, and equity; mobilize all actors and institutions in the health community; and launch a global competition to foster innovative interdisciplinary research and actionable solutions at the intersection of climate change and human health.  Several other private and governmental efforts are underway across the world.

What can you and I do to help?  Learn more about these impacts and the response.  Inform and educate our friends and family. Support ongoing efforts and advocate for local and national programs to combat it. We cannot afford to do nothing. The health and Sukham of our fellow humans and that of future generations are at stake!

Mukund Acharya is a regular columnist for India Currents. He is also President and a co-founder of Sukham, an all-volunteer non-profit organization in the Bay Area that advocates for healthy aging within the South Asian community. Sukham provides curated information and resources on health and well-being, aging, and life’s transitions, including serious illness, palliative and hospice care, death and bereavement. Contact the author at sukhaminfo@gmail.com.

 

Sleep Tight, Sleep Right

A good sleep cycle ensures optimal health, so monitoring how you sleep and practicing proper sleeping habits is essential for a healthy and fulfilling life. There are many adverse effects to improper sleep: Harvard Medical School found a strong link between depression and insomnia; one out of five Americans have obstructive sleep apnea; and an NCBI report also speaks of the elevated cardiovascular disease and type 2 diabetes mellitus risk observed in South Asian population and the potential of sleep interventions to minimize this disparity.

Mattress Matters

During sleep, our bodies repair themselves having a healing effect on our psychological processes as well. According to the Harvard Medical School, there are more than 70 types of sleep disorders with the most familiar being insomnia, obstructive sleep apnea, and narcolepsy.

“While several factors affect sleep quality and cause sleep deprivation, one of the major causes that can usually escape our notice is the mattress that you sleep on. A bad mattress can ruin your sleep, making it hard for you to fall asleep as well as stay asleep for eight to nine hours every night. It can also impact the blood circulation in the body, affecting the amount of deep sleep and rest you get during a sleep cycle. And if you have sleep-related health issues and even chronic back pain, then a bad mattress can further worsen your condition. Therefore, investing in the right kind of mattress is extremely important to improve your sleep quality,” says Chaitanya Ramalingegowda, Director & Co-founder, Wakefit.

Mattresses being made at the Wakefit factory.

A good mattress should distribute your bodyweight uniformly so that you do not wake up with pain in your neck, shoulders, and hips. The mattress should not unnaturally bend your spine thus causing back pain and postural defects.

Smita Murarka, Vice President, Marketing & E-commerce, Duroflex adds, “a comfortable and supportive sleep surface is the key to unlock great sleep. Our range of mattresses and research-backed and scientifically engineered to provide optimum support and comfort. Our signature range Duropedic has an advanced 5 zoned orthopedic support system that provides differential support for different parts of the body. This technology has been tested and recommended by doctors by the National Health Academy.”

Act Now

Lack of sleep can have significant repercussions on one’s physical and mental well-being. The weakened immune response, decrease your ability to concentrate, impair your cognitive function, increase the risk of injury and physiological ailments, cardiovascular diseases, diabetes among others. Lack of sleep can have an adverse on your mental health as well. It can impact your mood, ability to handle stress and reduce emotional resilience. If you are experiencing morning headaches, daytime fatigue, loss of focus, you must consider getting tested.

“The recently launched OneSleepTest by Ectosense with a small disposable NightOwl sensor is a comprehensive and reliable home sleep test kit that guarantees accurate results. It provides a verified e-report from a sleep physician and sleep coach assistance enabled by ResMed in 3 to 5 days post the test period from the comfort of your home,” says Dr. Sibasish Dey, Head, Medical Affairs, Asia and Latin America, ResMed.

Tech Talk

Digitization in the healthcare industry has revolutionized the diagnosis and treatment of sleep disorders and has brought it to our homes’ comfort. With cloud-connected technology and remote monitoring, most mild to moderate sleep disorders can be treated without having to be hospitalized and in a cost-effective way. With the availability of numerous sleep tracking devices and apps, it has become easier to understand your sleep patterns and even identify disturbed sleep reasons. You can wear tracking devices on your wrists, clip them on your pillow, or rest on the bedside table.

Balasubramanyam SV, Founder, Durfi Retail says “we recently rolled out India’s first Hempseed oil-infused mattress, Durfi is the first company to develop and marketing this product in India, this product also a blend of tech and tradition. Hempseed oil infused cotton candy memory foam mattresses are India’s first natural oil-infused mattress, the mattress surface is softer and cozy, the mattress provides great comfort to the body posture.”

Tools & Techniques

Aromatherapy is a holistic healing therapy that uses natural plant essential oils to promote health and well-being and can have a positive impact on sleep too.

Lotus seeds and milk from ITC

“Lavender, Marjoram, Chamomile, Sandalwood, and Neroli are the main ingredients that have shown properties of calming the nerves and promoting relaxation. They can be taken in the form of teas, rubs, in diffusers, in your bath or directly applied to the skin before bedtime. However, the right combination and formulation is important,” says Karina Kapoor, Brand Head of Puressentiel.

Bindu Gopal Rao is a freelance writer and photographer from Bangalore who likes taking the offbeat path when traveling. Birding and environment are her favorites and she documents her work on www.bindugopalrao.com.

 

Madhumeha: Ancient Origins, Recent Epidemic

Diabetes has existed for millennia. It has been recognized by several ancient cultures including Indian, Egyptian, Chinese, and Persian. Sushruta, a surgeon and physician who lived around 600BC in the Varanasi area in northern India, documented it in his works. They recognized that ants were attracted to the urine of affected individuals and it was named Madhumeha (Sanskrit; madhu- honey).

Ancient physicians also recognized that there were two types of conditions that involved excessive urination and loss of weight. This recognition of excessive sugar in individuals affected by diabetes was refined over the next 2000 years, and in the 18th century, England Johann Peter Frank is credited with the identification of two forms of diabetes- diabetes mellitus and diabetes insipidus. Mellitus (Greek; honey) was associated with high levels of sugar in the urine, while insipidus was not. In fact, diabetes insipidus is an unrelated condition related to hormonal control of the kidneys, leading to excessive urination. 

By the 5th century physicians in India and China had noticed that there are two kinds of diabetes mellitus- one of which was prevalent in older and heavier individuals. Methods to recognize, understand and treat diabetes mellitus have evolved with technological developments. Relatively rapid progress since the 18th century has identified insulin as the hormone secreted by the pancreas that plays a central role in this indication, and also defined type 1 and type 2 diabetes.

Type 1 (also termed ‘early onset’ and ‘insulin dependent’) is a condition that generally develops in children and younger individuals where insulin production by the pancreas is compromised or completely shut down due to several reasons. Type 2 diabetes (also termed ‘adult onset’ and ‘non-insulin-dependent’) is the focus of this article and has become a global health problem. 

In its current trend of prevalence Type 2 diabetes, or T2D, has blurred two boundaries. It was previously confined to low- and middle-income countries but is now on the rise even in the higher-income countries. Secondly, the age of onset is not confined to older patients. Among the Indian population worldwide, T2D is gaining numbers within India and also within expatriate Indian and southeast Asian communities. Some studies put the number of Indians in the US as the group with the highest incidence of diabetes than any other racial group at an age group above 20. Similar reports have been made with respect to Europe and UAE. Within India itself the numbers of T2D in adults 20 years and above has tripled over the past 3 decades.

This appreciable increase in T2D in southeast Asian expatriate communities, and also within their countries especially India and China, is thought to be due to the relatively recent cultural changes in diet and lifestyle over the past 50 years, such as an increase in consumption of fried foods, fast food, refined grains and sugars, lack of dietary fiber, and sedentary lifestyles.

In addition to these behavioral changes T2D is caused by an interplay of genetic and environmental factors, and familial history serves as an indicator for individuals to be forewarned about their own health. That said, considering the speed with which changes in the age of onset and frequency of T2D are being documented, it appears that environmental, diet, and lifestyle changes are the major contributors to the current epidemic. Also, in general, Indians have a higher degree of insulin resistance than Caucasians, which occurs when the cells of the body lose the capacity to respond to insulin even when it is being produced by the pancreas. 

The burden of the long-term health effects of T2D are significant to the individual and from a public health perspective. The more stark chronic manifestations include neuropathies, foot ulcers, blindness, kidney dysfunctions, accelerated aging, and a general decline in health and productivity. In addition to insulin, newer medicines exist to control blood sugar and insulin response, and other therapies are being developed including stem cell therapeutics. 

If there is a good aspect to T2D it is that it can be prevented or the onset delayed. The fact that onset can be delayed is a point of practical importance, as most of the clinical manifestations arise due to cumulative effects of high circulating sugar. Prevention is the best cure, as the adage goes. A regular health check-up will flag a ‘pre-diabetes; condition. Glucose intolerance tests, HbA1c levels in the blood, body mass index, and overweight are common tests to gauge pre-diabetes. This indication should be taken as a warning, and acted upon seriously and with a positive attitude. 

The trinity of diet, exercise, and stress management are often called upon. Eat less. Eat on time. Walk more. In general, the lifestyle changes that are recommended are geared towards helping maintain an even level of blood sugar and reduction to, or maintenance of, an optimal body weight.

Processed grains, and refined carbohydrates like maida (all-purpose flour), have a high glycemic index. As against whole grains, they are quickly metabolized to sugar and result in a sudden spike of increase in glucose in the blood. Our standard fare includes white rice or chappatis/other breads as a base, and this can be substituted with brown rice and atta (whole wheat).

Instead of serving up a plate with a large portion of rice and sides of vegetables and protein, switch around the amounts and serve up rice as a side dish instead. Control portion sizes, and maintain steady time intervals between meals and snacks. Include soupy low-calorie items which will serve to fill up the stomach. Fasting is not recommended. Eat a diet of high fiber which includes green leafy vegetables and excludes starchy vegetables, skim milk-based yogurt, and whole grains. High fiber dals (moong, masur, urad, etc., along with sprouted whole dals) and beans (such as chole and rajma) should be a mainstay. Including methi (fenugreek) regularly in cooking, and in salads and dals after sprouting (sprouting methi completely reduces its bitter taste) adds flavor and a health benefit. Fruits that are delicious and low in sugar include papaya, guavas, blueberries, and jamoon. 

Items to be conscious of and exclude, or eat in disciplined quantities, include fried foods and fatty foods in general (including our delicious tea-time snacks!), foods that include sugar and artificial sweeteners (yes, some sweeteners and bulk additives added to sweeteners can produce a sugar spike!), and processed grains. While regulating these will help with the maintenance of body weight, avoiding sugar, sweeteners and the inclusion of whole grains will maintain even levels of blood sugar. Depending on the stage of diabetes fruits may be eaten in moderation, but high sugar fruits such as mangoes, grapes, and sapotas should be avoided. 

As with diet, steady exercise is highly recommended for diabetes. Even our hoary sage Sushruta recommended this, and in some studies, the inclusion of exercise had the most obvious ameliorative effect. The type of exercise will need to vary based on the individual’s age and capacities, but even a basic activity like a daily brisk walk for about thirty minutes would make a difference. Obviously, more will be required if weight loss is an objective. Although yoga is excellent for weight maintenance, it will not suffice for weight loss regimes. Walking, yoga, and exercise, in general, will also help in stress management, and others may be included, such as reading, meditation, etc., depending on individual preferences. 

Tackling the diabetes epidemic at the global level would need to start with the individual. 

L Iyengar has lived and worked in India and the USA. A scientist by training, she enjoys experiencing diverse cultures and ideas. She can be found on Twitter at @l_iyengar .

 

My Bones Just Lit Up Says Indira Ahluwalia About Her Battle With Cancer

Indira Ahluwalia is tall and graceful with a warm, welcoming smile. She’s the picture of wellness and good health, or so you’d think.  Her story, however, is about an illness that inspires dread, but it’s a remarkable and inspiring one.

In 2007 Indira was told she had metastatic breast cancer which had spread to her bones. She did not have long to live. But since that devastating diagnosis 13 years ago, Indira has beaten the odds and has not simply lived, but thrived.

Her  forthcoming book, Fast Forward to Hope, describes the tortuous, but ultimately awe inspiring journey through the dark crevices of her disease, and the toolkits for survival she developed which she firmly believes, contributed to her recovery.

“I remember the day I went to my gynecologist’s office so well,” Indira says. “I had coped with a terrible back pain for weeks and was walking around with a cane. I had an appointment with an orthopedic doctor but then a new symptom appeared. I felt this awful shaft of pain from the underside of my right nipple all the way up my arm; it was a live, electric wire thing, and it prompted me to make an appointment with Dr. Maser, my obstetrician-gynecologist, immediately.”

That trip led to an immediate mammogram which diagnosed her breast cancer and her doctor insisted she get a PET scan.

“I had already been through an MRI for my back pain, but without contrast, and it didn’t show anything. But when I had the PET scan, my bones just lit up,” Indira recalls. “Dr. Maser, an incredibly supportive doctor, came out and held my hand and said to me “promise me you’re going to fight.”

The full meaning of what it meant to have the cancer in your bones didn’t hit Indira till later.

“I visualized a tiny, pinkie size spot somewhere, and was horrified when I saw the spread.”

The process of getting the right diagnosis is one of the first lessons in Indira’s book.

“My father had colon cancer and we were very conscious of taking care of our health and testing on time. I began having colonoscopies when I was 35. But I was 38 and had never had a mammogram. I simply didn’t see the connection or imagined it was a risk at my age. I didn’t know at the time that there is a genetic connection between colon cancer and breast cancer. It’s important not to underestimate your risk in any area, was the first lesson I learned. It’s also important to get every technologically advanced current diagnostic test done. My MRI without contrast hadn’t picked up the cancer in my bones.

Her second lesson was about the will to survive. At the time, her children were young: her son was 3, her daughter had just turned 5. After going through every stage of grief – denial, shock, anger and finally, acceptance, – Indira came to the conclusion that dying before she raised her children was simply not an option.

“You have to believe in what you want the outcome of your illness to be,” Indira says. “I had a simple choice – living or dying – and I was determined not to die. You also have to commit yourself to healing and not let a feeling of powerlessness or helplessness overtake you. I had some very low points in my treatment, when I had to actively cultivate my faith in the positive outcome I wanted – beating back the cancer. There is an enormous capacity all of us carry within us for self-healing and we need to believe in it, with gratitude and humility.”

 Indira’s strong conviction about the healing power of positive thinking is borne out by recent research that supports the power of optimism and faith in changing the course of serious illness.  She also found that being open about one’s suffering and disease brought enormous rewards.

“The first thing that comes to my mind from my ordeal is the goodness of people,” Indira declares. “I knew there was a stigma associated with cancer, but I was open about my illness and I was overwhelmed by the response I got from all sorts of people – friends, family, staff, clients, my children’s Montessori teachers, unknown strangers. She believes that given and opportunity, even random strangers offer unconditional kindness and compassion.”

She recounts a particularly moving incident. On a cab ride from her office in Ballston, the cab driver surprised Indira with a, “Oh, my God, it’s you!”  He explained he’d driven her home some months ago, “…. you were talking to your doctor and you’ve been in my prayers ever since.”

“It was the simple humanity of his words which really touched me,” Indira says.

“Another of my primary anchors was my faith,” affirms Indira. “I believe in the Sikh tenet of Chardi Kala which is, essentially, cultivating a state of eternal optimism as one goes into battle. And I was going into battle with my cancer, with all the resources I could muster, including my state of mind.”

Her doctor told Indira he had used her first diagnostic scan from thirteen years ago and her most recent scan, to teach a class of medical students. He presented them as scans for separate individuals. His students diagnosed the thirteen year old scan as that of a patient unlikely to live, but gave the latest scan a great prognosis. His students were astonished when they heard that both scans belonged to the same person.

“My doctor told me that they needed to bottle the magical elixir I’ve used to beat back my cancer and distribute it to all his cancer patients,” Indira recalls.

 “I’ve tried to share what I learned about my magical elixir in the book,” Indira says.” Writing it was a cathartic process and it lays out the essentials in terms of harnessing the science of your disease along with your faith and your social network, and creating your personal anti-cancer army. I really hope I can help others who may be going through a similar trauma. My advice to them: choose yourself and visualize your cure with all your heart.”

Indira’s book, Fast Forward to Hope, will be out in late April 2021 and will be available on Amazon and in Barnes and Noble and local bookstores.

Jyoti Minocha is an DC-based educator and writer who holds a Masters in Creative Writing from Johns Hopkins, and is working on a novel about the Partition.

Edited by Meera Kymal, contributing editor at India Currents

 

Notes From an Indian American Ayurvedic Massage Patient

(Featured Image by Prakriti Ayurveda Center)

Veena and Devi, the two young women who were to be my massage therapists, start their procedure with an invocation to Dhanvantari, the god of medicine and Ayurveda. At the end of the invocation, they chant ‘lokah samastah sukhino bhavantu’ (may all beings everywhere be happy and free) three times in their clear voices, every day, for the seventeen days of my treatment, taking turns to stand in front of me, right palm on the top of my head where a few drops of warm herbal oil have been dribbled to start the routine. I sit there on the massage table in nothing but a skimpy konakam (loin cloth), mesmerized by the sounds and simple tune of the invocation that bounces off the bare walls of the treatment room. 

This last line spins in my head like a song that is stuck in a good way. The tune stays true to theirs but the words change to ‘let go, surrender, savor the moment’. The only way to savor each moment is by learning to let go. Letting go, as in disconnecting the body from the mind. To stop thinking of body parts as ‘buttocks’, ‘breasts’, ‘thighs.’ Most of all, to get rid of identifying these body parts as mine. Only then am I able to relax and enjoy the power of touch – the main sense awakened during the treatment.

Once the invocation is over, the ears are at rest – the massage is done in silence. The only sound is the drone of the ceiling fan. Occasionally, sounds seep in from the outside, like the caw-caw of a crow in the neem tree or the drawn-out ‘pay-paar’ call of the recycling trader, bicycling the neighborhood shopping for old newspaper. I close my eyes through most of the hour in order to better take in the smells – the next most salient sense that is evoked during these massages. Fragrances fill the room – herbal oils, camphor, roasted pumpkin, wild brown rice, boiling milk.

Image by Prakriti Ayurveda Studio

Apart from some perennially inflamed finger joints, I did not have any major problems when I walked into Prakriti, the Ayurvedic center close to where I was staying on this trip to Chennai. But I had time on my hands so decided to check it out. The doctor, also a young woman, very well-spoken, spent an hour with me asking me questions. She told me how Ayurveda treats not just symptoms but works holistically on the entire body. Most treatments improve blood circulation and remove impurities at a cellular level, thus reducing inflammation. She prescribed a detox and rejuvenation regimen that included a series of three massage treatments supplemented with two kashayams (a liquid decoction of medicinal herbs), and a ksheerabala capsule. 

I remember ksheerabala from my childhood – it was my grandmother’s wonder drug. It didn’t come in capsule form then. My grandmother always had a skinny 3-inch bottle of this dull yellow oil and she would apply a few drops to the scalp on the top of her head. Unlike other herbal oils, I remember from my childhood, this one didn’t smell good so I was glad to see it come wrapped in a bright green capsule now.

I was expected to eat simple vegetarian food for the duration of the treatment. The three massages, which I’ll get to, were udvarthanam, elakizhi, and navarakizhi in that order.

Unlike many Ayurvedic clinics especially built for the purpose, Prakriti is housed in a rented home on a quiet street in Chennai. All three bedrooms with their attached bathrooms have been turned into ‘treatment rooms’. I realized very quickly that an Ayurvedic massage is not for the faint-hearted. Nor the bashful. One of the women leads you to a treatment room, locks the door, and hands you your disposable konakam. You change into it in the bathroom, though I’ve wondered why I bothered with the bathroom – walking back into the room in that little white loin cloth was more embarrassing especially since a post-menopausal body isn’t exactly a showpiece. You face your masseuse and sit on the massage table with your legs dangling over the side.

After the invocation, one masseuse applies more warm oil on your scalp and hair and massages your head and temples for about ten minutes – heavenly. You then lie on your back on the wooden massage table that shines with all the oil it has absorbed over the years. The bottoms of your feet are wiped clean. Warm oil is poured on your stomach, chest, and limbs, and is worked into your body with Veena and Devi on either side of the table and four strong hands moving swiftly in tandem. Then you lie face down and the process is repeated except sans konakam. These first few steps are the same for all seventeen days. The medicinal massage follows the oil massage and is different for each kind of treatment. The ceiling fan is turned off during the medicinal massage. 

Treatment Room at Prakriti Ayurveda Center

In udvarthanam, which I did for three days, the kizhi (read ‘kiri’) had a mix of medicinal powders. Kizhis is a Malayalam word that means bundle. Various medicinal substances and rice are tightly held in a cloth. It is used with or without moisture for massaging the body. It is heated in a dry pan and applied to your body in upward strokes. Some of the powder seeps through the cloth so you smell brown and earthy by the end of all the scrubbing. It is mixed in with the smoky fragrance of the kizhis getting heated. There is a twenty-minute rest period at the end of the forty-minute massage. 

The elakizhi was seven days of intense massage. The kizhi is filled with medicinal leaves that smelled like roasted pumpkin and is dipped in hot oil before being applied on your body. ‘Apply’ is too soft a word. It was more like pat-pat-pat, pound-pound-pound, scrub-scrub-scrub all over, front, back, limbs, until you felt like pumpkin pulp. There is a thirty-minute rest period at the end of the forty-minute massage. 

Navarakizhi also lasted seven days. It was the gentlest of the three but the most labor-intensive and hence the most expensive. The process starts the day before with 12 liters of water mixed with medicinal herbs boiled down to 1.5 liters. Milk is added to this and a special variety of brown rice called Navara is cooked in this kashayam (decoction of medicinal herbs) until soft. The kizhis are filled with this cooked rice and heated in boiling milk before being applied. The strokes in navarakizhi are circular in motion and feel satiny on your body. Mushy starch oozes out covering you in a soft film of pinkish brown, the color of my palm but lighter. You feel cool as soon as this massage starts. There is no rest period. 

I was surprised at how easily I fell asleep during the rest periods and sometimes even during the massage. Lying on my back on a hard, wooden table with a tiny two-inch-thick plasticky pillow would hardly have qualified as comfortable. Yet, I almost always had to be woken up at the end of the rest period. 

The last step of the session is the ‘bath’. You sit on a plastic stool in the bathroom and one of the women ‘bathes’ you. She scrubs your body with a mung dal paste that removes all traces of oil and herbs. She applies shikakai (Acacia Concinna) paste to clean your scalp and hair. Hot water is poured all over your head and body. By the time you finish and step out, you are ready for another nap.

As imagined, I was relaxed and rejuvenated at the end of the seventeen days and sorry to see it end. It has left me, however, wanting more such ‘treatments’, perhaps at lush locations with the sound of waves lapping against a seashore…

Lakshmi Narayanan lives in Ann Arbor MI when she is not spending time in Narberth, PA with her two grandkids, or traveling. Pre-pandemic travels included one or two trips a year to India. A recent longer stay allowed this experience.