Hyperparathyroidism

What is Hyperparathyroidism
Hyperparathyroidism is an increase in parathyroid hormone (PTH) levels in the blood.
 This occurs either from a disorder within the parathyroid glands (primary hyperparathyroidism) or disorder outside the parathyroid glands (secondary hyperparathyroidism) resulting in them making too much PTH.

Symptoms
Symptoms may be so mild and nonspecific that they don't seem at all related to parathyroid function, or they may be severe. The range of signs and symptoms include:

Fragile bones that easily fracture (osteoporosis)
Kidney stones
Excessive urination
Abdominal pain
Tiring easily or weakness
Depression or forgetfulness
Bone and joint pain
Frequent complaints of illness with no apparent cause
Nausea, vomiting or loss of appetite

Vitamin K

Vitamin K
Used mainly in clotting and anticoagulation activities.

Vitamin K deficiency occurs in several situation
1.Fat malabsorption syndrome.
(a disorders in which the small intestine can't absorb enough of certain nutrients and fluids. Nutrients that the small intestine often has trouble absorbing can be macronutrients (proteins, carbohydrates, and fats), micronutrients (vitamins and minerals), or both.) 2.After destruction of Vit K- synthesizing gut flora by antibiotic.

3.Following birth of newborns.Liver reserves small amount,the gut flora has not developed,level of Vit K in breast milk is small.

4.Diffuse liver disease.

Consequences
In adult,it causes bleeding diathesis.
It means unusual susceptibility to bleed (hemorrhage) mostly due to hypocoagulability (a condition of irregular and slow blood clotting), in turn caused by a coagulopathy (a defect in the system of coagulation). This result in
a)Hematomas(solid swellings of clotted blood within the tissues)

b) hematuria (blood in urine)

c)melena(black tarry stools, which usually occurs as a result of upper gastrointestinal bleeding)

d)ecchymoses(discoloration of the skin resulting from bleeding underneath, typically caused by bruising)

e)Bleeding from the gums.

Thymus, DiGeorge Syndrome and Thymus Thump

The thymus gland plays an important role in the development of a normal, healthy immune system.
 The function of the thymus gland is to generate mature T lymphocytes (white blood cels that help the immune system fight off illness). Do adults need thymus gland?
The thymus gland, located behind your sternum and between your lungs, is only active until puberty
The thymus is special in that, unlike most organs, it is at its largest in children. Once you reach puberty, the thymus starts to slowly shrink and become replaced by fat. By age 75, the thymus is little more than fatty tissue. Fortunately, the thymus produces all of your T cells by the time you reach puberty

What and where is the thymus gland?
The thymus gland, located behind your sternum and between your lungs, is only active until puberty. After puberty, the thymus starts to slowly shrink and become replaced by fat.

What are the symptoms of an enlarged thymus?
Tumors in the thymus can press on nearby structures, causing symptoms such as:
Shortness of breath.
Cough (which may bring up bloody sputum)
Chest pain.
Trouble swallowing.
Loss of appetite.
Weight loss.

What is DiGeorge Syndrome.
Children born without the thymus.

What is Thymus Thump
The Thymus Thump (also known as the happiness point) can help to neutralize negative energy, exude calm, revamp positive energy, support healing and vibrant health, and boost your immune system. A simple but very effective energy technique involves tapping, thumping or scratching on the thymus point.

Vitamin B12

Vitamin B12 does a lot of things for your body. It helps make your DNA and your red blood cells, for example.

Since your body doesn't make vitamin B12, you have to get it from animal-based foods or from supplements. And you should do that on a regular basis, because your body doesn’t store vitamin B12 for a long time.

Causes:
-Inadequate intake
-Vegan
-Pernicious anaemia
-Gastrectomy
-Bacterial overgrowth
-Crohn’s disease -Terminal ileum resection
-Coeliac disease
-Tropical sprue
-HIV
-Metformin(Diabetes med)
-Proton pump inhibitor (gastritis med)
-Pancreatic deficiency

Symptoms of Vitamin B12 Deficiency

If you have vitamin B12 deficiency, you could become anemic. A mild deficiency may cause no symptoms. But if untreated, it may lead to symptoms such as: -Weakness, tiredness, or lightheadedness -Heart palpitations and shortness of breath -Pale skin -A smooth tongue -Constipation, diarrhea, loss of appetite, or gas -Nerve problems like numbness or tingling, muscle weakness, and problems walking -Vision loss -Mental problems like depression, memory loss, or behavioral changes

What are the complication of B12 deficiency?

Megaloblastosis can cause multi system effect notably cardiomyopathy and neurological disease examples such as subacute combined degeneration of cord, peripheral neuropathy and dementia.

Is there a risk in administering a blood transfusion in the setting of B12 deficiency?

In mixed anaemia with severe B12 deficiency,B12 should always be replaced before transfusion because transfusion can precipitate heart failure.

Seizure

Type of Seizures?
Seizures are classified into two groups.

Generalized seizures affect both sides of the brain.
*Absence seizures, sometimes called petit mal seizures, can cause rapid blinking or a few seconds of staring into space. *Tonic-clonic seizures, also called grand mal seizures, can make a person
-Cry out.
-Lose consciousness.
-Fall to the ground.
-Have muscle jerks or spasms.

Focal seizures are located in just one area of the brain. These seizures are also called partial seizures. *Simple focal seizures affect a small part of the brain. These seizures can cause twitching or a change in sensation, such as a strange taste or smell. *Complex focal seizures can make a person with epilepsy confused or dazed. The person will be unable to respond to questions or direction for up to a few minutes. *Secondary generalized seizures begin in one part of the brain, but then spread to both sides of the brain. In other words, the person first has a focal seizure, followed by a generalized seizure.

What you shouldn't do?

Do not hold the person down or try to stop his or her movements.

Do not put anything in the person’s mouth. This can injure teeth or the jaw. A person having a seizure cannot swallow his or her tongue.

Do not try to give mouth-to-mouth breaths (like CPR). People usually start breathing again on their own after a seizure.

Do not offer the person water or food until he or she is fully alert.

Dear God,

I can't say it in words,
Can you please listen through my heart,
Tell me that your plans are better than my dreams?
God.

Safe Way of Scuba Diving

During ascent phase of a dive, the gas in the diver's lung expands due to the decreasing pressure.
The diver must therefore ascend slowly and breathe regularly.
If ascent is rapid or the diver holds his breath,the expanding gas may cause lung rupture (pulmonary barotrauma).

How to Know If You're Immune System is Weak

Leukemia vs Aplastic Anaemia

Abdominal Lump

The peritoneum is the serous membrane forming the lining of the abdominal .The outer layer is the parietal while within peritoneum is intra abdominal.

Intra peritoneal means within peritoneum while retro means behind the peritoneum.

PARIETAL VS INTRA- ABDOMINAL
-Can be ascertain by either head rising or leg rising test.

When you lift your head and shoulders,if the swelling disappears or become less prominent,then the swelling inside the abdomen (Intra abdominal).

If the swelling becomes more prominent or remain the same then it's parietal.

For lower abdominal swelling,lying on bed and lifting both the legs bring the same interpretation as head rising test.


INTRA-PERITONEAL OR RETROPERITONEAL

Do a knee elbow position .
If the lump disappears or become less prominent,then its retroperitoneal.If swelling becomes more prominent or remains the same, it's intra-peritoneal.

Overcoming Pain

Yesterday,I was having a conversation with my mum.It was actually an unnecessary topic that she started from no where.That 'what if' kinda topic most mother had in them.
What if you're wife do this and how would you react?
It's always seems annoying when she started such topics.I don't even in a relationship with anyone in the first place.
I don't pick a side because unlike everyone, I'm not that kind of son that fond of mother.It wasn't my mistake purely.A part from childhood dramas,that's her way.

I have never even hugged her,sleep on her lap nor hold her hand for more than a couple of seconds.
Maybe it happened when I was a baby but I can't recall such incidence from the age of realizing what's happening around.
Sometime I wished she could be different or I could be different but changing the whole thing isn't possible anymore.
She said something that made me took a pause to reflect on my thoughts.
"When you're in my house,your wife..."
I felt, I'm doing everything, earning, creating business, postponed my medical posting for her sake.Maybe I can't feel such a love towards anyone,even her but the responsibilities is always mine.That's how I framed my mind.
She could said,"When you're in our house..."
After all, I'm gona get a house not for me,It was for her..
This reminded me of my ex's words replying me once.
"It's not we, it's you and me."
Seeing as us and seeing as you and I, seeing as we and seeing as me is not just a relationship issue.
It's a leadership quality I learnt.

Most of the time I realized, this pain of heartache is unbearable.It feels hard.You can't eat,you can't sleep ,you barely living while you're still breathing.
It's a super extremely undesirable feelings but if you went through it and survived, nothing could break you anymore.
The problem is, psychological pain is equally painful as physiological pain in our mind.So it's not just a mind thing that we can change in a day by altering our mindset and perception.

Most of the time, whenever we want to achieve something,it started in our mind.Maybe as an idea,a thought, positive belief.
Action speaks louder than words but words are more important than action.Words are the initiator.Action is a reaction to a creation.
Don't believe me?
While you're reading this,say your name in your mind?
Pallavi?
Can you listen it?
Yes of course but we know our vocal cord doesn't vibrate,no sound energy was produced as we know that we can listen to a sound because of the vibration that converted into sound but how you heard your name in your mind?
That sound,that words, it's more important  than action.
In term  of heartache and breakup,this technique doesn't applicable honestly.
You need to do the reverse.
Positive thinking will never helps. Only positive action helps.
That action slowly create an illusion  that you can actually change your current state.
Be it pain, addiction or bad habits,you can't change them by stopping them.You have to replace the existing with something new.


Changing pain into laughter isn't possible at all unless you're in a new relationship but remember,if you don't heal your past wound before you go to someone,you will cause pain in them.That shortcut isn't the best option.
Pain should be corrected with a pain before you become happy for real.

Pain-->pain-->Best of you.
Let's go deeper.

Heartbreaking pain(negative pain)
        |
Self building pain (positive pain)
       |
Make you stronger,create a sense of belief that you can go through it which eventually you can.(time is the denominator)
     |
The past memories is there but it won't control your life anymore.

We can't forget anything but we will learn to live totally fine with the past.
It wont be erased but the intensity will fade with time.
When you can laugh and talk about it with your friends, that's when you're fully recovered.

Current pain is like a coke in a glass.
You can't pour it out to correct everything.
You should replace them with water until you can't see the coke inside the glass anymore.The black water will change into white with time.
That emptiness will leads to more pain and destructive habits.
Alcohol, smoking and drugs during heartache is the seed and water of the pain.It looks like a solution for short term.
You can sleep at night,you can cope up and go through your day but long term,it makes things worse.

And if you're having all of them like me once, that's a terrible state to be,trust me.

Meditation,gym,talk with someone doesn't help me at all.I was doing everything yet destructive .I workout,I meditate ,I talked with friends but the pain remains.
That's when I bring that positive pain.
I forced myself to eat things without sugar and salt,when I meditate, I meditate under cold shower.Every morning and night even during winter,I only take a cold shower.I changed all my workout sets to pattern and drop superset which was very painful and exhausting.
I punch the punching bag until my skins on my knuckles torn and yet I do push ups with knuckles just after the punching session.
Each time when I punch that bag,I imagine my ex,her friends and everything that cause this pain to me.

I realized something, it's not just activities, I have been doing them even before but this time,the intensity,the new challenges that I brought into action and the main thing, I replaced the negative pain with constructive pain but if you notice it,I wasn't mourning, I was in rage.
Rage is one of the best feeling that I ever experienced.
Pain can drain you or fuel you but in order to make the pain to fuel you,you need to change that heartbreaking pain into rage.
From negative energy it shifted into positive energy.
Along with progress and compounding effect, things will be different.

It wont happen in a day.
This notion that things will change in 21 days was first create by a plastic surgeon.He notice that even after surgeries,the patient still unhappy with their new look.Their old negative perception of themselves took 21days to change.To completely change and adapt their new look and believe that they're looking good,it takes 66 days.
So as I mentioned in the formula,time is the denominator in this situation.

Don't see it as 66 days,focus today.This 24hours,one step at a time,step by step.
Utilize this 24hours,plan and execute the second better version of you.

Still feeling hard? Can't get rid of their thoughts?I know that feeling.There's a secret that anyone can apply to get rid of that thoughts.Will share in my next post.

The Secret Formula of Happiness | How To Be Happy

21st May 2019.
The moment I opened my eyes,I checked the time on my watch.
1145a.m.
Later than usual but it's fine, yesterday's midnight show wasn't that terrible after all.
Routines- Apple cider, exercise, meditate, affirmation,few minutes with instrument and some positive videos.Was watching TedTalk and it made me wondered.
I saw my niece.She sleep,she wake up,eat,watch cartoons for hours,run here,play there,shit and sleep.The the next day, the same routine continues.
Everyday it's almost the same, just at times there will be some variation but it's the same pattern.
You,me,the entire world is facing the same aren't we?
Just that some people's life is more saturated with dramas, emotion stirring events,be it good or bad.
That experience is the reason why two person can never experienced life as the same.The joy,the fun the sadness,the struggle,it can never ever be the same.
Local holidays and oversea's holiday aren't the same experience.
Struggling childhood,and a happy childhood creates different future.Kids from third world country and kids from developing countries leads a different life.

When someone says you never know what I faced, decorating their small pain as if as devastating tantrums,I quietly observe their dramatic presentation.

That's not wrong but exaggerating is our mind trying to create the best screenplay.With time,even the originality of the event changes because the mind remember what it remembered.
What does it mean?
It means,human mind doesn't goes 20 years back to recall that childhood moment.It goes to the last moment when you recalled them.If you recall that memory 6 months 8 days ago, that's where it went.

So what's this entire life is about?
This compounding, collective accumulation of moment leads us into different stages of life. Initially we are carefree and then we started to study.
Then?
We started to learn.Some learn how to learn,while the rest go with the unproductive flow. We use  education to attain a job.That ensure  us food and shelter.

This entire cycle is about moments.
MEMORIES.
We human, insects, snake's, elephant,moon, asteroid are made from the same elements of periodic table.
Same dough,but different shapes and form.
Some can talk, some have tail,some can breath in water and land, some are poisonous,some are venomous. Such a marvelous creation.Same material but the creativity is infinite.

Maybe this entire life is about creating and collecting memories.
I tried to recall my childhood . I was a little fortunate because my childhood is super dramatic.It's not lame and boring as my niece.For years I thought I was cursed but today I learnt that, that's the blessing.
I can recall things that happened when I was 2 and half, 3 ,4 years but the mid period,8 years old to 15 years;not that much.
Secondary school moment and med school memories are fresh as well, thanks to my exs.
I realized, rather than that laughing,joy moments,things that make us experience the moment intensely,sad, excited, thrilling and challenging lasted freshly and longer in our mind then the rest.

Years from now,how would it feels if I created such exciting experiences around people around me.
Maybe when I recall them back,it would be more fun,maybe the lessons and relationship that I made along the way would make people to remember my name for 100 years after my demise.

Hence I wondered, what's the role of happiness then?How to be happy?How to attain and sustain it?
I realized,these questions itself is a trap.
Happiness is like money.
For some they know how to earn it,for some they know how to save it and for some they know how to spend it,but to be the master of all 3,only the 1% of population could do that.Even if you does,your 100dollar bill that you owns today might be someone's elses tomorrow.
Happiness isn't a stagnant feelings.
It comes and goes.
Why?
Environment? Circumstances? Hormones? Food ?The parameter goes on.

I had the question in me for years.How to be happy?
Maybe my question was wrong all these years..
How can I be happy?
Maybe I'm not allowing myself.Maybe you don't know you can create them.If it's a feeling,then it's a perception , right?
If it's a perception, it's kinda an emotion.I applied First principles thinking and digged deep down.
If it's an emotion, it's mainly a mind stuff.

I realized this when I thought about the slum kids.They have nothing,pants with a hole,poor skin condition,dirty yes,they are dirty,many health issues but they never bother about them and played happily..Why?
Maybe because they're kids and they aren't exposed to the reality yet.
Then I came across poor rickshaw pullers,those roadside beggars that happily laughing,having good times with their pals.
I had money in my pocket, smartphone,good clothes, medical student,in simple word, I'm living a life 50 times ,perhaps 100 times better then them,but I didn't smile, miserable .I thought I'm the only one but once when I turned and looked at my friend,he was in a state no different than me.

What's the secret? What's wrong?
Then one day,I sat to complete my surgery case histories that I have to submit tomorrow.10 all together.Each case would be 6 7 pages.I knew it gona be a bad evening.
I started with a single sentence.
I thought let's write them in a beautiful handwriting.
Time to time I felt,the writing was good and nice for a lazy male.
Page after page and I don't feel irritated as if I achieve the flow.
Once in awhile when my fingers ached,I stopped and I look back.The entire handwriting seems impressive for me.I was happy and I don't know why and how this sudden shift happened.
I realized something that day,
When we create something that challenges us and we witness the progress and take a moment to appreciate the effort,It felt extremely good .

Create +challenge yourself
             |
      -Observe the progress
      -Take a moment to appreciate the effort
             |
    =Ended up loving the process. Everything that you hate seems likeable.

That's when I realized, happiness and good time is created.Not externally but internally, first in your mind.

When problems are seen as a challenge and we try to figure out a solution with our own creative terms,it feels different than the feeling that we felt when we dwell with the problem feeling hopeless and overwhelmed.

What happens if I could apply this formula and a sense of knowing that it's all about creating the best experience even during toughest day.


Heart aching problem
          |
Plan a creative way to solve it.That problem it self is a
challenging situation.
           |
      -Observe the small progress.
      -Take a moment to appreciate the effort, evaluate what's working and what's not .
Realize that a week from now this shall pass and you going to create an experience that you will excited recalling back.
20 years from now, it will be a good story to share with your grandkids.
             |
What would we feel?


Trying to solve it self is a different vibe,the emotion of solving and dwelling and crying is different.The energy and the mindset is different.

Happiness and living is a mind thing.There is where we should look into if we want to be happy but to tackle more chronic life problems,it can never be solve in few steps or method.
Like building a car,the base,body, engine,the battery ,oil,painting everything is a different element brought together for a perfect conditioning car.
We humans are more sophisticated machines and we too needs few other methods along with this.

What's the next method?

Excess Protein in Diet /Protein Poisoning

Met an interesting person today,perhaps a case.
Rabbit starvation.
Low blood pressure, diarrhea, headache, tiredness,slower heart rate than normal,food craving that  can be satisfied only by the eating
fat.
It is also know as protein poisoning,a rare form of acute malnutrition caused by a near complete absence of fat in the diet.

Meat and fat should be consumed in the correct ratio. Excess in one and complete absence of the other groups for prolong period doesn't serve us well.

Are you a Chicken or an Eagle?

"One day,a young boy climbed high in the mountains nearby his father's chicken farm & found an eagle's nest.He took an egg out of the nest, brought it back to the farm and put it with the chicken eggs under a setting hen.The hen sat on the eggs until they hatched & out came a little eaglet along with chicks.The eaglet was raised among the chickens and never knew it was anything else but a chicken.It lived a normal chicken's life but as it began to grow,there were strange stirrings within.
Every once in awhile it would think,'There must be more to me than a chicken' but it never did anything about it until one day a tremendous eagle flew over the chicken yard.
The thought came,"I'm like that.A chicken yard is not for me.It had never flown but the power and instinct were within.It spread its wings and was lifted to top of a low hill. Exhilarated ,it flew to a higher hilltop and finally to the summit of a high mountain peak."


He continued," Remember , nobody can be you as efficiently as you can."
"That's pretty parable but I'm not neither a chicken or an eagle.I'm human.Just an ordinary one,"I sighed.
"Some of the greatest thing in this world have been accomplished by men and women who never knew what they couldn't do.Not knowing,they just went right ahead and did it. Believe it."

What if..? 7th May 1988

Food, water, land. The very elements we need to survive are owned by corporations.There's no food for us on trees, no fresh water in streams,no land to build a home. If you try and take what the Earth provides, you will be locked away.

For years we sit and regurgitate what we're told. Tested & graded like subjects in a lab. Raised not to make a difference in the world. Raised to be no different. Smart enough to do our job, but not to question why we do it.

Where there were trees that cleaned  our air,are now factories that poison it. Where there was water to drink, filled with toxic waste that stinks.
Animals that run free,now slaughtered endlessly for our satisfaction.

Over a billion people are starving despite us having enough food for everybody. Where does it all go?
70% of the grain we grow is fed to the animals we eat for dinner.
Help the starving?We can't profit off them.

We tearing apart the very environment that allows us to live.
What happens when we have polluted the last river?
Poisoned the last breath of air?
We aren't destroying the planet.
We destroying all life on it.

After 9 years being the first to wish her on her birthday,I decided to stop but the prayers remains; forever.

😪