Varicose veins – in a nutshell

Lots of people are worried that they have/might get varicose veins.
I thought that I should provide some thing short and sweet for anyone who wants to know more about this particular condition.
Obviously this is a problem affecting the veins of the body, most commonly the legs.
Blood vessels that carry blood from the various parts of the body to the heart are known as veins, they have one-way valves that prevent blood from flowing backward. If the valves become weakened, some blood can remain in the vein, causing the vein to enlarge and bulge.
• Smaller congested veins close to the skin are commonly referred to as spider veins.
• Larger congested veins are found mostly in the legs and are commonly called varicose veins.
No one knows the exact cause of congested veins, but heredity, aging, pregnancy, and prolonged sitting and standing may contribute to the problem.

Whether varicose veins need to be treated, is generally up to the individual. Some people request treatment because of the appearance or discomfort of varicose or spider veins.
Congested veins can worsen over time, causing sensations of heaviness, cramping, or burning. The most severe cases may cause swelling in the legs and feet, skin ulcers, or blood clots.

How can this disorder be treated?
Options for treating large varicose veins:
• Elevating your legs as often as possible;
• Wearing elastic support stockings;
• Sclerotherapy;
• Surgery to remove the veins;
• Wait and see.
Options for treating spider veins:
• Sclerotherapy — small needles are used to inject a chemical solution into each varicose vein, causing the vein to close. Blood is rerouted to other veins.
• Laser ablation — sends intense bursts of light onto the veins to seal them off, causing them to dissolve over time.
• Thermal ablation — is similar to sclerotherapy, except the veins are sealed off with an electric current instead of a chemical solution.

Researchers are still evaluating which treatments are most effective for cosmetic and long-lasting results.
Surgery is preferred for severe varicose veins. Sclerotherapy is recommended for recurrent varicose veins after surgery. Most of the procedures can be done in an outpatient setting.

What should you discuss with your doctor?
Talk to your doctor about referrals to specialists who do vein treatment or surgery. You should ask the specialist which treatment might be successful in your case. You should also know congested veins may return after surgery. Most insurance policies do not cover treatment for varicose veins if it is done only to make you look better, but if you have physical symptoms, too, insurance may cover the treatment.

What can I do to prevent it from getting worse?
Doing simple things like elevating your legs, wearing support hose, exercising regularly, keeping your weight down, not crossing your legs when sitting, and eating a high-fiber diet to avoid constipation will help prevent varicose veins and relieve discomfort from the ones you have.

Tea and me

I was basically someone who did not drink tea or coffee unless I had an exam a few days away and I really needed to stay awake and study. One fine day I decided to try something. I decided to make the perfect cup of tea and looked up the Internet for instructions on how to make the perfect cup of black tea. I finally got everything I needed to make the tea, and made it just as they said in the recipe. It was good. But then I had made a little extra so I left it there and sat down to study something. After a while of studies I came back for a snack and saw my tea there again, this time it was cold and I tasted it and thought “Wow!” this is good stuff.

I drank up and went back and hit the books again. At the end of the day while lying in bed at night I realized that I had completed all the topics I had set for myself for that day and was not as drained out as usual. I went over the events of the day and realized that it was an ordinary day with the only exception being that I had two cups of tea. The next day I decided that there must be something about tea that I had not known until now and decided to do some research. What I found, amazed me, and now I’m a firm believer in the beneficial effects of tea.

Here were some of the problems that used to worry me:
• My dad has diabetes and I was afraid I would also end up diabetic.
• I wanted to lose a few kilos.
• I had to study hard for my post grad exam which was around the corner and I kept forgetting stuff that I had read a month back.
Here are some of the things that I found:
• Black tea increases your metabolic rate. Clinical trials conducted by the University of Geneva and the University of Birmingham indicate that green tea raises metabolic rates. In addition to caffeine, green tea contains catechin polyphenols that raise thermogenesis (the rate at which calories are burned), and hence increases energy expenditure.
• It also apparently increases endurance in exercise by improving fat metabolism.
• Tea speeds up fat oxidation and improves insulin sensitivity and glucose tolerance, this is really good news for diabetics (I did not say you can start adding sugar in the tea though)
• John Foxe, Ph.D., professor of neuroscience, biology and psychology at City College of the City University of New York, found that theanine is absorbed by the small intestine and crosses the blood-brain barrier, where it affects the brain's neurotransmitters and increases alpha brain-wave activity. The result is a calmer, yet more alert, state of mind. (Exams, here I come!!)
• In 2003 the Brigham and Women's Hospital released details of a research project which indicated that theanine may help the body's immune system response when fighting infection, by boosting the disease-fighting capacity of gamma delta T cells. The study included a four-week trial with 11 coffee drinkers and 10 tea drinkers, who consumed 600ml of coffee or black tea daily. Blood sample analysis found that the production of anti-bacterial proteins was up to five times higher in the tea-drinkers, an indicator of a stronger immune response.
• According to a study by UCL researchers, drinking black tea lowers stress hormone levels. Just 50 minutes after a high stress event, tea drinkers, who had been drinking 4 cups of black tea daily for a month, had a 20% greater drop in cortisol than the placebo group. Blood platelet activation, which is linked to blood clotting and the risk of heart attacks, was also lower for tea drinkers.

And that is not all, the list goes on. But it was enough to convince me.

But for us Indians there is one more piece of news that we need to keep in mind.

All of this information refers to studies where the tea did not have any milk in it!!
A study at the Charité Hospital of the Berlin Universities showed that adding milk to tea will block the beneficial effects that tea has in protecting against cardiovascular disease. This occurs because casein from the milk binds to the molecules in tea that cause the arteries to relax. Tea protects against cancer but one you add milk this benefit is lost again. So the take home message is drink tea, leave out the milk (and sugar for diabetics) and stay happy.

Hypoglycemia and hyperglycemia. What you should do if you get it.

Many people with diabetes don't really know what to do when they have an very low or very high sugar level readings.

Here I explain some easy, practical things to keep in mind.
If the sugar levels in your blood are very low (Hypoglycemia) you might feel some of these symptoms:

• Shakiness, jerky movements, dizziness, seizure, sweating, hunger, headache, perspiration, difficulty speaking, difficulty paying attention, pale skin color, tingling sensations around the mouth, feeling anxious or weak

In such a case, this is what you should immediately do:
Drink a soft drink like Pepsi, 7up, Sprite, etc. In case only sugar is available then take one or two tablespoons of sugar and mix it in some water and drink it.
Once you feel better eat a healthy, long-acting carbohydrate to maintain blood sugars in the appropriate range. Half a sandwich is a reasonable option.
If the hypoglycemic episode has progressed to the point where you cannot or will not take anything by mouth, you need to make sure someone around you knows how to give you a glucagon injection. A response is usually seen in minutes and lasts for about 90 minutes. Again, a long-acting source of glucose should thereafter be consumed to maintain blood sugar levels in the safe range.

I recommend that you sign up for a YosCare account so that you can take a print out of an emergency card and keep it with you always. It’s free, takes 5 mins and in an emergency it could save your life some day. Just click on the title to go to the YosCare login page.

If the sugar level in your blood goes up very much (Hyperglycemia) you might feel the following symptoms

• Early signs: Increased thirst, Headaches, Difficulty concentrating, Blurred vision, Frequent urination, Fatigue (weak, tired feeling), Weight loss, Blood glucose more than 180 mg/dL,
• Prolonged hyperglycemia in diabetes may result in: Vaginal and skin infections, Slow-healing cuts and sores, Decreased vision, Nerve damage causing painful cold or insensitive feet, loss of hair on the lower extremities, and/or erectile dysfunction, Stomach and intestinal problems such as chronic constipation or diarrhea,

Here are some measures that you can take if you know (after a blood test) that you have hyperglycemia:
• Drink more water. Water helps remove the excess glucose from your urine and helps you avoid dehydration.
• Exercise more. Exercise will help to lower your blood glucose.
Caution:
If you have type 1 diabetes and your blood glucose is over 240 mg/dL, you need to check your urine for ketones. When you have ketones, do NOT exercise.
If you have type 2 diabetes and your blood glucose is over 300 mg/dL, even without ketones, do NOT exercise.
• Change your eating habits. You may need to meet with the dietitian to change the amount and types of foods you are eating.
• Change your medications. Do not make adjustments in your diabetes medications without first talking with your health care provider.

When one has hyperglycemia for a prolonged duration, the body starts breaking down fats for energy. When fats are broken down a substance called ketones are released into the blood which if not managed early can lead to a dangerous condition called Ketoacidosis.
Symptoms include:
• shortness of breath
• breath that smells fruity
• nausea and vomiting
• a very dry mouth
In such cases rush to the emergency department to see a doctor.

Diabetics their fears and some solutions

All Diabetics will remember the day they were told they had diabetes. Different people react to the news in different ways.

Questions foremost in the mind of a new diabetic’s mind are:

• ‘Is it serious?’
• ‘Am I going to die?’
• ‘Will I get better?’
• ‘Am I going to lose my legs like that lady in the waiting room?’
• ‘Will I go blind?’
• ‘Will I lose my job?’
• ‘Am I going to lose my driving license?’
• ‘Will I lose my boyfriend?’
• ‘What are you going to do to me now?’
• ‘Will I need to have injections?’
• ‘Will it hurt?’

In the near past there have been many advances in the management of diabetes; but the sad reality that stares society in the face whenever we look at the mirror with respect to diabetes and the way it is presently managed is that of the sad diabetic who wants to do whatever his doctor tell him to do but is unable to due to various reasons.

Let’s round up the usual suspects:

• 58% of people diagnosed with diabetes do not know what the diagnosis means
• More than 1/3rd do not know what questions to ask their doctor.
• 60% of patients with diabetes do not understand what different medicines are available,
• The few to whom the doctor explains the situation, many of them do not understand what their doctor is telling them
• Some people who get some printed material from the doctor are unable to understand the material as it is written.

All if this leads to a feeling of frustration, depression and helplessness.

A solution to the problem lies in providing personalized information that focus on individual circumstances and locally available services.This is what YosCare is aiming to address. We can provide the personalized information at the right time from among the locally available sources.

We seek to achieve this through encouraging more people:


• To understand what questions they need answered
• To prepare for their consultations by maintaining one single health record
• We also provide them with a set of tools that help them meet their doctor’s prescription.
• Thus helping them become an active partner in their treatment plan and thereby building their confidence to understand their condition and its treatment better.

Everyone recognizes that the first step to dealing with a problem is to learn as much as necessary about that problem. Hence the need for educating a diabetic about their condition needs no further discussion.
Then other issues that need to be addressed are then, why do they need a single health record, and why do they need a set of tools.

• The doctor will be able to efficiently tailor the personalized treatment plan if he has all the information that he requires while examining the patient. Therefore to ensure that the patient receives the best quality of care, it is imperative that his health record needs to be up-to-date and available at the time of the consultation.
• The set of tools are a convenient way by which the patient is able to systematically record and maintain his records, while being alerted to the treatment plan that his doctor has developed for him and other guidelines that must be followed for better clinical and quality of life outcomes.

We believe that such an interconnected system which addresses the special needs of a diabetic will go a long way in improving diabetes care in the present day scenario.