DOCTOK

Walking may not be as simple as it looks. It’s a complex process that involves a network of signals between the brain and the muscles in the arms, back, abdomen, pelvis, and legs. Here’s the intriguing part. According to research, the pace and flawlessness of the walk may be a deep reflection of what’s going on inside your brain and how well you are aging. Perhaps this explains why some of us have that spring in our steps, while some wobble.

Why does this happen, and what warning signs should we heed when our walk is disturbed?

This and more in our blog.

The physiology of walking

To understand how our brain functions, let’s draw an interesting analogy. Just as the body loses muscle mass, strength, and quality with age, the nervous system also undergoes a process called atrophy. This is when the nerves in the body become less efficient and reduce in number. Experts say that you lose around 0.1% of neurons every year until the age of 40, and the losses increase as you age. By the age of 90, you would’ve lost almost 150g of brain tissue.

Hence, while young people have robust motor and mental function, they can effortlessly manage the multitasking that walking requires. For older people, their gait becomes less automatic, and they rely on other cognitive sources to walk. Now, if these cognitive sources are scarce, especially because of conditions like dementia and Parkinson’s, the pace and stability of the walk can be significantly affected. The thumb rule is to watch your gait at the age of 45. According to studies, the age of 45 is a strong predictor of how your physical and mental health will be in the coming years.

The walking pace and health conditions

A disturbance in the walking style can be one of the first warning signs of neurodegenerative conditions like Parkinson’s Disease, Diabetes, narrowing of the arteries, vitamin deficiencies, and infections. Let’s look at the different disturbances in the walking style and what’s causing them.

• Slow and unsteady walk- Parkinson’s Disease usually interferes with the messages being emitted by the brain to the musculoskeletal system. This slows down the gait of a person, making it less synchronized and stable. Doctors say that the first indication of Parkinson’s is shorter strides and a longer duration taken for each stride.
• Tripping- The process of walking is designed in such a way that our feet move in a synchronized way and stopping us from tripping over. This is made possible by the muscles in the front of the shin that pull the foot upwards and swing it forward. In some people, this mechanism begins to falter, leading to falls. Research has indicated that Diabetes causes nerve damage, which causes frequent falls. 
• Differences in the step length- A study published in Medical News Today that involved around 110 persons above the age of 60 with mild cognitive impairment, early stage of Alzheimer’s, and dementia revealed that the subjects had a noticeable decrease in memory and displayed differences in step length and the time it took them to take each step. The group also showed an asymmetrical walking pattern. In Alzheimer’s disease, the damage initiates in the hippocampus, a brain area that is essential for memory formation, while in dementia, the parts of the brain that take care of movement and some aspects of memory are affected. This causes the person to become disoriented and display a noticeable change in the length of each step. 
• Toe-walking and crouching- Cerebral palsy deeply affects a person’s muscle strength, spasticity (contracture of muscles which can make walking difficult), and motor control. This leads to initial changes in the gait of a person and is characterized by walking on toes, crouching, and circular movement of body parts, especially the hands and legs. 
• Dragged walk- Stroke disrupts neural pathways that are responsible for movement. When walking, the person tends to hold their limb to one side and drag their affected limb due to weakness. This causes the person to spend more energy while walking, take shorter steps, and also decrease their walking pace.
• Balance issues- The condition, Multiple Sclerosis(MS), strongly targets the nervous system. According to an article published in PubMed, ‘walking changes in MS include reduced gait speed, impaired walking balance, and reduced walking-related physical activity. Falls in people with MS are associated with injuries, reduced participation, and increased fear of falling.’

However, experts insist that gait changes may not always be a result of brain disorders. They attribute abnormal gait to Vitamin B12 deficiencies, excessive consumption of alcohol, and certain infections.

The best bet? If you or your loved one observes consistent changes in the way you walk, consult a doctor. Proper medical guidance can always give you an edge toward better health.

We all have a resounding ‘one’ to the question, ‘How many hearts are there in your body?’, but what if we were to tell you that our body doesn’t have one, but two hearts? 

And this second heart, although not located in the heart cavity, is equally important for maintaining blood circulation throughout the body.

Where this second heart is hidden and how it contributes to keeping the body healthy and functioning is what we are going to cover in our blog.

The second heart and the circulatory system

The circulatory system delivers oxygen to different cells throughout the body. It is comprised of vital organs and vessels, namely the heart, arteries, veins, capillaries, and, of course, the blood that is carried by these vessels. With the assistance of arteries and capillaries, the heart draws blood containing oxygen(oxygenated blood) from the lungs and pumps it to millions of cells in the body. Once the cells have captured the oxygen and have been fed, the deoxygenated blood goes back to the heart through veins, which constitute the venous system. This blood is then re-oxygenated in the lungs.

This is where the second heart comes into the picture. 

There are two types of networks of veins that run through our bodies. One is the deep vein system, which has large veins that run close to the bones, and the other one has superficial ones that are present under the skin; those are the veins that we can sometimes see. These two systems meet at two junctions within the body. One is at the groin, and the other behind the knees. The proper flow of blood within the venous system without a backlash is the result of the heart’s pumping force and the contraction of the calf muscles, which consist of the soleus muscles and other muscles. The veins open and close with the help of valves with each muscle contraction. This muscle-vein-valve system is the second heart.

The job of the second heart is not an easy one, as it has to pump blood back to the heart against gravity.

The system is called the second heart because it assists the heart in returning the deoxygenated blood and distributing the blood efficiently in the lower regions of the body.

When the second heart doesn’t function normally

When you don’t move your calf muscles for a prolonged period, it can cause the second heart to not function normally. This results in:

• Blood and toxins accumulating in the legs, leading to swelling and fatigue.
• Blood clots forming in the veins, causing serious health conditions like deep vein thrombosis, leading to severe pain, swelling, and multiple other medical conditions like varicose veins, spider veins, etc.
• Additional burden on the heart and affecting the cardiovascular wellness.

How to keep the calf muscles and the second heart activated?

The key to activating calf muscles is movement. Sitting for a long time, a sedentary lifestyle, and a lack of physical activity can all lead to the weakening of calf muscles.

This is what you can do

1- Walk- Doctors and other medical professionals have been advocating walking for several health reasons. This one can be called the most important one. Each step you take while you walk contracts the calf muscles to raise the flow of blood to the upper part of the body. A brisk 20-minute walk during the day can do the trick.

2- Exercise- This one has been shouted from the rooftops for decades now. Exercises like calf raises, calf stretches, and ankle rotations have significant positive effects on the blood circulation.

3-Regular movement- If you are one of those at a desk job, the idea is to stand up and move every 30 minutes instead of sitting for long hours.

4- Compression- For immobile people, using compression socks is an effective way to improve blood circulation. Compression socks can also be used during long hours of travel.

The benefits of calf muscles being healthy means no clot formation and swelling as a consequence of improved blood flow, elevated energy levels as a result of improved delivery of oxygen and nutrients, faster recovery time in case of an injury or illness since calf muscles will be stronger and able to circulate blood properly, and a fit and less loaded cardiovascular system.

If you need help with calf strengthening exercises, our skilled and vigilant physical therapists can help you save and keep the second heart in your body running healthily and well.

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The healthcare workers put up a brave front every single time. Be it during endless hours of an emergency, the passing away of a patient, and feeling helpless when situations don’t go according to what they had hoped and worked for. Yet behind that seemingly unbreakable steel facade are just regular human beings who go through the same highs and lows and carry the same emotional baggage. The difference is that they are not allowed to show it or maybe even speak about it, and this emotional residue keeps accumulating in their hearts and bodies, emerging as silent depression and burnout.

The disturbing data

According to the National Library of Medicine (NIH), ‘there is now a wealth of evidence showing that work is a major determinant of physical and mental health. Recent studies have suggested increased rates of depression in healthcare workers (HCWs) in the context of the COVID-19 pandemic, with direct impact on care quality and productivity.’ This primarily happens because most of the healthcare workers don’t have the time to pause and care for themselves, and even if they develop signs of mental disturbances, they are usually reluctant to seek professional help. But what they fail to register is that these mental disorders, if not addressed, can significantly affect their well-being and pose a great risk to their professional practice. Research has further revealed that health professionals go through anxiety, insomnia, depression, and other symptoms that hint towards trauma. While most who go through difficult phases bounce back, however, when they are exposed to mental disorders, especially during epidemic outbreaks, their chances of recovery diminish. The World Health Organization has estimated a shortfall of 18 million health workers by 2030, mostly in low- and lower-middle-income countries. 

What do experts say?

According to experts, the COVID-19 pandemic has exacerbated mental health issues amongst the overburdened healthcare task force. There are several reasons for the same. The heavy workload, prolonged shifts, a frenzied pace of work, absence of consistent self-care, moral dilemmas, job security, and at times, a lack of support. This has led to depression, burnout, anxiety, and sleep issues, and has had a significant impact on the productivity, efficiency, quality of care provided, and the overall health of workers. They call for a serious and dedicated effort to identify and mitigate the risk factors to safeguard the mental health and wellness of one of the most important task forces in society.

Dr Shefali Jha, a physician based out of Nashik, shares that, “Healthcare workers are trained to put the patients first. Hence, thinking about ourselves or our needs doesn’t figure much on our priority list.” The doctor goes on to add that healthcare workers have a certain public image of selflessness, and therefore, they fear judgment from others and experience guilt if they think of attending to their own needs. A better work-life balance and self-care care however, would enable all health workers to enjoy more satisfaction in their work and overall life.

Benefits of good mental wellness in healthcare professionals

• Better emotional and physical well-being.
• Ability to provide better care for patients with more compassion, sensitivity, effectiveness, and empathy.
• Helps create stability during difficult times to manage stress more efficiently.
• Emotional resilience facilitates better decision-making and problem-solving abilities and leads to enhanced optimism and personal efficiency. 

Practices to improve mental wellness in health professionals

• Being aware- The first and maybe the hardest step toward ensuring better mental wellness is developing a sense of awareness of one’s emotional needs, stress levels, and being willing to take breaks when required. 
• Lifestyle changes- Making a conscious effort to make certain healthier changes to the daily routine goes a long way. These are, taking a nature walk, meditating, being mindful while eating, establishing a consistent eating schedule, getting sufficient sleep, practicing some form of physical exercise, pursuing a hobby, meeting with family and friends often and finding a way to express and release emotions through either journaling or some creative work and talking to a friend or a therapist instead of repressing them.
• Thinking about strengths- Posing questions like how things could have been different or thinking negatively about oneself is very easy to engage, but healthcare professionals have to strive to think about their strengths and accomplishments to keep the desire and energy to continue.
• Decluttering and prioritizing- The most suitable thing to do to ensure that one does not get stressed is by prioritizing the work to be done and even doing one thing at a time. They should ease their work by outsourcing it, set healthy boundaries by learning how to say no, and use assertive communication.
• Reaching out for help- There is no cause for embarrassment in terms of seeking help whenever there is a need for it; whether a friend, colleague, or a professional counsellor to relieve the physical and emotional load and get back to work even stronger and more motivated.

The role of government and society in helping health workers be happier and healthier

For too long, the burden of being brave and performing ceaselessly has been on the healthcare workers. It’s time to pass the baton. Healthcare professionals maybe usually be referred to as heroes without a cape, but they are human beings at the end of the day. They are not invincible warriors, and they have their emotional and physical limitations. Gratitude, empathy, and respect from patients’ families go a long way in making them feel good and worthy of all the time and effort they have put in. On a higher level, the government can introduce a better reward and appraisal system and invest in better protective and preventive measures in the healthcare system to decrease the burden on healthcare professionals in the long term. It is also equally important to provide mental health support facilities to healthcare workers through mental health support programs and timely psychological interventions. A great example is the Self-Help Plus (SH+) program introduced by the World Health Organisation(WHO) that aims to address high levels of stress and mental trauma in workers through acceptance and commitment therapy. Using telemedicine platforms can not only offer timely and effective care to patients, but it can also decrease the workload on doctors and other healthcare professionals. The same platform can be used amongst the staff to discuss various medical interventions, and psychologists to offer aid to the workers when needed.

The narrative around mental health care for healthcare workers needs to change, and not be considered a luxury. The lifegivers can’t continue to keep pouring from an empty cup, and it’s time that an effective system is formulated that provides the caregivers the space and resources to heal themselves.

Let it be cardiac issues in young adults — the silent threat is claiming lives when least expected. Akshay was at home in South Bengaluru when he suddenly collapsed. When his family rushed him to the hospital, he was declared dead. 

Harish, another resident of Chikanahalli in Bengaluru, experienced sudden chest pain and passed away in the hospital due to a cardiac arrest.

Manjiya Naik in Davangere passed away due to a heart attack while driving his auto rickshaw.

Why are we listing these that appear to be regular cardiac issues cases?

The deceased individuals were 22, 56, and 38 years old, respectively, and had no history of heart problems.

If we have your attention, this is what some of the senior cardiac specialists have to say. According to them, many young adults are being diagnosed with Acute Coronary Syndrome(sudden heart attack), and the majority(almost 50%) of patients who have visited the hospitals are between the age group of 40 to 50 years, indicating a huge health crisis that may be looming over our society.

The situation calls for a detailed investigation of the risk factors and protective strategies and measures to be taken, especially in the Indian context, where this demographic seems to be at a major risk.

We did a little bit of digging from our side, and here are our consolidated findings that may help you save your and your loved ones’ hearts before it is too late.

The Covid-Heart Connection

According to doctors, multiple complications have been reported amongst patients after COVID-19 recovery, and cardiac issues in young adults are the most common ones. Before the pandemic, acute corona problems were observed in people around the 50s, but now people in their 30s and 40s are being diagnosed with cardiac issues. This finding has solidified the fact that most people who have passed away due to sudden cardiac arrest have at some point in their lives been affected by COVID-19.

The doctors have observed that people around 50 years of age take medications such as Statins, Anti-hypertensives, Aspirin, etc, which protect them from acute coronary artery disease. However, people in their 30s usually don’t consume any such preventive medications and hence are vulnerable to sudden cardiac attacks.

What does COVID do?

COVID-19 infection makes the heart muscle cells die, resulting in shortness of breath and chest pains.

Studies also accuse inflammation in the presence of COVID-19 infection, which activates the immune system of the body. Though the common inflammation results in the formation of inflammatory cells and cytokines that are beneficial to the body, excess inflammation may cause damage to the cardiovascular system in more than one way. It leads to irregular heartbeat(arrhythmia), clots in the blood with a possibility of causing blockage in the blood vessels, heart muscle inflammation(Myocarditis) and inflammation of the membrane around the heart(Pericarditis), and heart failure.

Talking about the COVID-19 vaccine, recent research has determined that the vaccine can hasten Myocarditis and Pericarditis, but as per the British Heart Foundation, the possibility of myocarditis and pericarditis following a COVID-19 vaccine is low.

Yet in opposition to that consideration, an article published at National Library of Medicine (NIH), claims that blood clotting, thrombosis (formation of clots in blood vessels), and increased blood viscosity are clinical issues that may potentially emerge following vaccination against COVID-19 and, once combined with other conditions of the heart, may overload it and lead to severe heart problems.

Hence, cardiologists advise all who have been affected by COVID-19 to undergo a heart examination to rule out any complications and ensure heart health.

Vaping is the new culprit

Introduced as a way to help people quit smoking, vaping has found its way into the lifestyles of many young adults. But here’s the truth. Vaping raises the blood pressure and boosts the heart rate up to 45-minutes post-use of e-cigarettes. The augmented cardiovascular rate and pressure may on its part escalate the vulnerability towards heart attacks and cardiovascular diseases.

Besides, vaping also makes the arteries harder and damages the endothelial cells lining the blood vessels; hence, placing the hearts of young adults at risk.

Vaping can also influence the cholesterol levels as much as traditional smoking does, raising the triglyceride and bad cholesterol levels.

Physicians are urgently encouraging individuals to stop vaping to prevent heart disease as well as to protect the lives of a lot of youthful individuals who have become victims of the pastime.

We cannot help but also mention substance abuse here. Cocaine’s impact on the heart is no mystery. It raises the heart rate just like e-cigarettes do, tightens the blood vessels, and causes elevated levels of blood pressure, straining the heart significantly.

Stress levels and hypertension

Blame it on the fast-paced lives, skewed work-life balance, or the societal norms, the young adults today are facing more pressure to perform, spend, and lead a certain standard of lifestyle. This has caused their stress levels and blood pressure levels to soar. High blood pressure is one of the biggest risk factors for cardiovascular disease, and it is, unfortunately, rising faster in young adults. High blood pressure thickens the muscles of the heart, damages the blood vessels, and increases the risk of heart attacks. 

The disrupted lifestyle has led to unhealthy eating habits, which have in turn caused elevated blood sugar levels, obesity, and negatively affect the heart.

High blood sugar damages blood vessels by deposition of fat buildup in the arteries and causes atherosclerosis, while the extra weight burdens the heart, making it work harder and eventually give up.

Change is necessary

While unhealthy habits and lifestyle choices may have been building up for years, the rise in cardiac issues in young adults today is alarming. We may not always pinpoint the exact trigger, but what we can do is act — now. Making the change before it’s too late can give your heart the strength it needs to thrive.

At Sukino, our cardiac rehab program supports your recovery and helps you build a heart-healthy life.

Since their discovery, antibiotics—once hailed as miracle drugs that could eliminate deadly infections—have saved millions of lives, but today they face a growing threat: Antibiotic Resistance, a silent and insidious health crisis with the potential to undo decades of medical progress.

You have probably heard the term somewhere before; however, what does it mean, and why does it matter to you? Let’s explore.

What Is Antibiotic Resistance?
The resistance between the antibiotics and the bacteria is a change that happens when the bacteria start to have the capability of defending against the effects of the antibiotics, which were initially effective in killing the bacteria. This implies that infections are more difficult to cure, take more time to treat, and are more likely to cause complications, hospitalization, and even death.

In simple English: The bacteria end up being more intelligent than the medication.

What Is The Reason Behind This?

The resistance does not occur instantly. It is cumulative, and in most cases, it is due to the way we employ (or rather over-employ) antibiotics.

The significant reasons are:

• • Antibiotics overuse (against viral diseases such as the common cold or the flu)
• • Partial use of antibiotics (quitting drugs when we notice that we are no longer ill)
• • Taking old antibiotics or self-medication
• • Doctor over-prescriptions are motivated by the demand of the patient
• • Excessive use in farming, where the antibiotics are used on livestock to stimulate growth

Whenever we use antibiotics irresponsibly, we provide bacteria with a chance to develop resistance and outwit the medication.

Why Not To Be Indifferent?

Antibiotic resistance is not some abstract, distant issue. It is already in process, it is touching adults and children, and it is all around the globe.

This is what it may mean:

• • Increased number of days in the hospital
• • More costly and poisonous therapies
• • Ordinary infections (such as UTIs or pneumonia) turning fatal
• • Higher risk when undergoing a surgery or procedure in which the danger of infection is high
• • The threat of antibiotic resistance by superbugs that cross the world

According to the WHO, antibiotic resistance belongs to the leading 10 threats to international public health.

What Are the Signs That Antibiotics Are Failing?

• • The absence of improvement in symptoms within 3-4 days
• • Symptoms worsening
• • Recurrence of symptoms following the discontinuation of antibiotics

The bottom line is that you should never touch your medication without consulting your doctor.

What You Can Do

Though scientists and policymakers are encouraging researchers to find new solutions, this is how the resistance wave can be contained.

• • Antibiotics should be taken with responsibility
• • Consume antibiotics that are prescribed by an accredited medical practitioner.
• • Do not hassle your doctor for giving antibiotics just because you have a viral infection.
• • Complete the whole course, although you feel better.
• • Do not self-medicate:
• • Never take any new medicine or use someone else’s prescription.
• • Do not purchase over-the-counter antibiotics without consulting healthcare practitioners.
• • Avoid infections by practicing personal hygiene, taking vaccinations, safe food handling, and maintaining social distancing, especially with people who are unwell.
• • Select beef, poultry, and meat poultry, which are free of regular antibiotics.
• • Buy the brands and support the policies that encourage the responsible use of antibiotics during farming.

Picture a world in which even a small wound is fatal. When an ordinary C-section or chemotherapy interventions turn risky due to the inability to battle any infections after such procedures. This has the potential to become a reality unless we take action now.
Antibiotics are a valuable, rare commodity. But if we keep abusing them, we will end up in a post-antibiotic world, where even the simplest bug will be fatal. Therefore, it is time to be careful before popping that pill. Let’s be better informed and more cautious, and safeguard our own health along with the health of society in general, and preserve these miracle drugs that can save our lives for generations to come.

Until a few years ago, cortisol was medical jargon spoken only in elite healthcare communities. However, it has recently become a household name, thanks to the global health and wellness diaspora. Everyone is talking about the hormone, and there is a very good reason as to why they are doing that. High levels of cortisol have been causing significant damage to the health of individuals in oblivion, and for years, the symptoms mentioned below that occur due to its elevated levels have been mistaken for serious medical conditions.

• Weight gain
• Fatty deposits between the shoulder blades
• Purple stretch marks
• Weakness in the muscles, especially in the arms
• Elevated blood sugar levels
• High blood pressure
• Increased hair growth in women
• Weak bones

If these symptoms have you worried, then we have some important news. The culprit is most likely cortisol (of course, after your doctor confirms the same), which has been affecting your brain and nervous system. The good part is that it can be regulated with simple meditative exercises and can rejuvenate you in unexpected ways.

What is cortisol?

According to the Cleveland Clinic, cortisol is a hormone produced in the body by the adrenal glands. It is an important hormone that affects all the organs in the body and is responsible for critical body functions such as regulating blood sugar, reducing inflammation, and regulating the sleep-wake cycle.

Most importantly, cortisol has a very significant connection with stress. Whenever a person experiences stress, the body releases cortisol, and every time it does, it alerts the nervous system and sends it into a fight-or-flight mode. High cortisol levels for a prolonged period mean considerable harm to the nervous system and consequently to the body.

What are somatic exercises?

Somatic exercises are like balm to the body after an injury. When the body is stressed out, the nervous system becomes alert, sensing danger and stays in that mode till it is reassured that the lurking danger has gone. These exercises are gentle body movements that help you calm down and gradually bring back the mind and the body to their original relaxed state.

While meditation has proved to be a great way to repair the damage stress does, somatic exercises go a step ahead and involve the body too, along with the mind, increasing the overall effect.

Our therapists have been specifically trained in somatic movements and exercises that bring down cortisol levels. This helps our patrons manage their anxiety and stress levels more effectively for optimal healing.

They suggest the following few simple exercises that go a long way in helping you rejuvenate and enjoy a better quality of life.

Somatic exercises that reduce cortisol levels

• The Somatic Breathing Reset

How it helps: Deep breathing stimulates the parasympathetic nervous system, which is your body’s relaxing mechanism.

The method: Stretch on your back with your knees bent. Put your one hand to your chest and the other one to your belly. Slowly breathe in through the nose to the count of 4. Breathe out, through the mouth, to the count of 6. Take deep breaths, focusing on your belly, not your chest. Do for three to five minutes.

• Pandiculation (The Body Natural Reset)

Why it helps: This is the yawn stretch reflex, which resets muscle tone and relaxes the nervous system.

The method: Deliberately strain your muscles (the neck, shoulders, and back) like how you stretch after waking up. Pause 35 seconds. Very gradually release the contraction and relax all the way. Put emphasis on the feeling of relaxation. Repeat three or four times.

• Constructive Empty Pose

Why it works: The position helps relieve the muscles of the back, neck, and pelvis, which are major places where stress resides.

The method: Rest on your back with legs folded at the knees. Put a small pillow under your head, if necessary. Relax your arms either on the side or belly. After this pose, take time to relax in this position and work on breathing and muscle relaxation for 10 to 15 minutes.

Extra benefit: The pose aids digestion as well as adrenal health.

• Mindful WalkingHow it helps: Unites light motion and somatic mindfulness, rooting you to the present moment and automatically reducing the amount of cortisol.

The method: Take a stroll around the house or outside. Concentrate on the feeling of how your feet feel in contact with the earth. Inhale and exhale as you walk. Be aware of how you feel in your body with every step you take. Walk for 5-10 minutes, distraction-free.

In a world that is obsessed with overachievement, we urge you to take a pause and slow down. Sometimes, spend time going beyond the outward appearance and looking inwards. Your body and mind may be silently asking for help before they give up.