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Friday, 20 February 2015 08:32

A stupendous success!

Written by Kamal Shah
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The First ever Dialysis Olympiad in India organised by NephroPlus was a huge success. Almost 350 patients and their attendants participated in the event this Sunday, the 15th of February in Hyderabad. Right from the morning, patients started participating in the various events that were conducted with great enthusiasm and a 'will to win' which was the theme of the event. Here are some pictures from the event:

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For more pictures, click here.

... http://www.kamaldshah.com/2015/02/a-stupendous-success.html


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Thursday, 19 February 2015 22:16

A little older in the shoulder

Written by Greg Collette
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For the last few weeks I’ve had a sore right shoulder.  I think it started at the gym.

I have been going to a gym of some kind for years.  I did a little boxing in my youth (light welterweight) and played rugby for a while (no 8) in the navy and have always liked to keep fit.

But then my kidneys morphed into Mr Potatoheads, and the gym became a bridge too far.

Eventually I began dialysis, and as my health improved, I returned to the gym and slowly got back some semblance of fitness.

However, kidney disease does take its pound of flesh.  Literally.  Over the years I have thinned down, and I find it takes a lot of effort to rebuild muscles and gain or re-gain weight.  This tendency to slim down over the years is called Sarcopenia (Greek, meaning “flesh poverty”), the progressive loss of skeletal muscle mass, quality, and strength as we age (up to 1% per year from age 25).  Of course, it’s not usually noticeable until we reach our seventies, but long term BigD tends to make it happen a little earlier.

So when I go to the gym, after my warm up, I tend to focus on muscle building via resistance exercises with weights, levers and the chest press.  Alas, about six weeks ago, I was straining to chest press what was clearly a petite level weight when something snapped in my right shoulder.  Uh oh.  Not good.  I stopped and decided to focus on a less strenuous exercise, like going home.

Since then my shoulder has been weak and sore, especially when I extend or raise my arm.  But most disturbing is that it aches when I dialyse.  Once the needles are in, I assume the position: arm extended a little, resting on a pillow on the arm of my chair so the needles can be seen and the blood can flow freely (we all know the position).  But now, after a few minutes, my shoulder aches and carries on, forcing me to move it constantly, and search for a more comfortable position.

Julie suggested I go to a physiotherapist she had found very helpful when she had a sore neck.  So I made an appointment.  I went to her yesterday and it was a revelation.  I was sceptical that she could help.  I had already decided that it was just a torn tendon or something, that would heal eventually, if I gave it enough rest (self-diagnosis is one of my secret gifts, though not yet evidence based, and exceeded only by my gift for self-treatment – also unproven).

But no.  After a range of questions about what exactly I was doing when it happened, the angles and movements that cause the most pain, and measuring the how far each hand could reach up my back (my right shoulder’s performance was embarrassing) she had the answer, and the solution.

Over the years as I sat at my desk, using my mouse to type, read, respond and relax, my shoulder has gradually moved forward, shifting away from its socket, compressing some muscles and stretching others, in particular the one under my shoulder blade.  That muscle may have been torn by my gym work, but the fundamental problem was caused by my posture, especially when using my mouse, and leaning forward to study my computer screen.

After some fairly brutal deep tissue massage and instruction about the how and when of future exercises, I emerged from the physio’s studio (parlour?), blinking at the light of day and the profundity of new knowledge about myself.

My shoulder will need a little more attention from the physio, together with regular bouts of rolling around the floor on my newly acquired roller (like a reverse rolling pin, with me as the pastry).  But I have every confidence that it will get better, and I hope to soon return to that chest press with bolder shoulder!

Stop Press:  On last week’s health and fitness segment on ABC Radio Overnights program I heard Gordon Lynch (Associate Professor and Reader in Physiology at the University of Melbourne) talking about some new research that could help anyone whose muscles are slimming down before their time, by Doubling Your Protein Intake (within the limits set by your kidney doctor**).  Studies at the University of Arkansas suggest that older adults may need to double up on the recommended daily allowance of protein to maintain and build muscle. The added protein seems to trigger our sometimes lethargic muscle-building cells into action.

So with a little more protein and some time back at the gym, I may not all get to look like Arnie, but maybe not his runt cousin either.

**People with early stage kidney failure but not yet on dialysis are usually on a reduced protein diet, to lessen the protein breakdown burden the kidneys.  Protein intake is regulated based on the stage of kidney failure (I put off BigD for years on a diet of jelly beans – which I now can’t abide).  But once we go onto BigD, this diet restriction no longer applies:  dialysis handles the waste, and protein, protein, protein is the order of the day (every day!).

... https://bigdandme.wordpress.com/2015/02/20/a-little-older-in-the-shoulder/


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Thursday, 19 February 2015 22:16

A little older in the shoulder

Written by Greg Collette
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For the last few weeks I’ve had a sore right shoulder.  I think it started at the gym.

I have been going to a gym of some kind for years.  I did a little boxing in my youth (light welterweight) and played rugby for a while (no 8) in the navy and have always liked to keep fit.

But then my kidneys morphed into Mr Potatoheads, and the gym became a bridge too far.

Eventually I began dialysis, and as my health improved, I returned to the gym and slowly got back some semblance of fitness.

However, kidney disease does take its pound of flesh.  Literally.  Over the years I have thinned down, and I find it takes a lot of effort to rebuild muscles and gain or re-gain weight.  This tendency to slim down over the years is called Sarcopenia (Greek, meaning “flesh poverty”), the progressive loss of skeletal muscle mass, quality, and strength as we age (up to 1% per year from age 25).  Of course, it’s not usually noticeable until we reach our seventies, but long term BigD tends to make it happen a little earlier.

So when I go to the gym, after my warm up, I tend to focus on muscle building via resistance exercises with weights, levers and the chest press.  Alas, about six weeks ago, I was straining to chest press what was clearly a petite level weight when something snapped in my right shoulder.  Uh oh.  Not good.  I stopped and decided to focus on a less strenuous exercise, like going home.

Since then my shoulder has been weak and sore, especially when I extend or raise my arm.  But most disturbing is that it aches when I dialyse.  Once the needles are in, I assume the position: arm extended a little, resting on a pillow on the arm of my chair so the needles can be seen and the blood can flow freely (we all know the position).  But now, after a few minutes, my shoulder aches and carries on, forcing me to move it constantly, and search for a more comfortable position.

Julie suggested I go to a physiotherapist she had found very helpful when she had a sore neck.  So I made an appointment.  I went to her yesterday and it was a revelation.  I was sceptical that she could help.  I had already decided that it was just a torn tendon or something, that would heal eventually, if I gave it enough rest (self-diagnosis is one of my secret gifts, though not yet evidence based, and exceeded only by my gift for self-treatment – also unproven).

But no.  After a range of questions about what exactly I was doing when it happened, the angles and movements that cause the most pain, and measuring the how far each hand could reach up my back (my right shoulder’s performance was embarrassing) she had the answer, and the solution.

Over the years as I sat at my desk, using my mouse to type, read, respond and relax, my shoulder has gradually moved forward, shifting away from its socket, compressing some muscles and stretching others, in particular the one under my shoulder blade.  That muscle may have been torn by my gym work, but the fundamental problem was caused by my posture, especially when using my mouse, and leaning forward to study my computer screen.

After some fairly brutal deep tissue massage and instruction about the how and when of future exercises, I emerged from the physio’s studio (parlour?), blinking at the light of day and the profundity of new knowledge about myself.

My shoulder will need a little more attention from the physio, together with regular bouts of rolling around the floor on my newly acquired roller (like a reverse rolling pin, with me as the pastry).  But I have every confidence that it will get better, and I hope to soon return to that chest press with bolder shoulder!

Stop Press:  On last week’s health and fitness segment on ABC Radio Overnights program I heard Gordon Lynch (Associate Professor and Reader in Physiology at the University of Melbourne) talking about some new research that could help anyone whose muscles are slimming down before their time, by Doubling Your Protein Intake (within the limits set by your kidney doctor**).  Studies at the University of Arkansas suggest that older adults may need to double up on the recommended daily allowance of protein to maintain and build muscle. The added protein seems to trigger our sometimes lethargic muscle-building cells into action.

So with a little more protein and some time back at the gym, I may not all get to look like Arnie, but maybe not his runt cousin either.

**People with early stage kidney failure but not yet on dialysis are usually on a reduced protein diet, to lessen the protein breakdown burden the kidneys.  Protein intake is regulated based on the stage of kidney failure (I put off BigD for years on a diet of jelly beans – which I now can’t abide).  But once we go onto BigD, this diet restriction no longer applies:  dialysis handles the waste, and protein, protein, protein is the order of the day (every day!).

... https://bigdandme.wordpress.com/2015/02/20/a-little-older-in-the-shoulder/


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Never before in the history of an Indian election has such a decisive mandate been given by the electorate to any political party. The soon-to-be-installed Arvind Kejriwal Government will have practically no opposition in the Delhi assembly.

Many analysts express deep concern on how a party that tends not to shy away from acts that cause people to describe it as 'anarchist' would behave when there is no opposition. Recent signs however show that Kejriwal and his team have learnt their lessons. They seem to have mellowed down, become more mature and sensible.

How did they manage to get such a huge mandate?

Conspiracy theorists claim that the BJP intentionally lost this election. Well, if it really was so, they would never have unleashed PM Modi during the campaign. Why would they want to tarnish his reputation of winning elections? The truth is that the people really wanted an AAP Government.

Is this is a referendum on the Modi government? I highly doubt this. People these days differentiate between the Centre and the State. Its been under a year since the Modi government took over at the Centre. Its performance, despite the huge expectations has not been bad. I don't think people would swing from a 100% verdict for the BJP to an almost 100% verdict against the BJP in such a short span of time.

Now, coming to the larger issue - of the impact of this election on national politics. Unfortunately, I don't think we are going to see much change in the way politics is run in much of the rest of the country any time soon despite the AAP victory.

The reason for this is that the AAP would first focus completely on Delhi and make sure that the promises it had made, especially with regard to a clean, corruption-free administration are fulfilled. Any attempt to look at other states would take away the focus on this. AAP is a young party with a very poor organisation structure beyond Delhi. It would be foolhardy of them to expect similar successes elsewhere due to this major handicap.

Despite PM Modi's best intentions on the issue of corruption, the BJP is pulled down by the baggage it has carried for all these decades. There are just too many people who are from the 'old-school' who believe in the culture of entitlement that afflicts the traditional political class in this country. And this is why he will fail when it comes to providing an administration that is as clean as one that the AAP can provide.

About other parties in the country, the less said the better.

... http://www.kamaldshah.com/2015/02/is-aap-delhi-victory-going-to-usher-in.html


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Monday, 26 January 2015 08:26

Announcing India's first ever Dialysis Olympiad!

Written by Kamal Shah
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NephroPlus is organising India's first ever Olympic style Games event for dialysis patients! We at NephroPlus firmly believe that dialysis patients can lead normal lives. What better way to prove this that organising such an event?

It is going to be a one day event conducted in Hyderabad. The event is open to all dialysis patients across the country. There are events like 50 and 100 meters sprint, 250 meters walkathon, 500 meters cycling, table tennis, badminton etc. For those not inclined to exert too much, there are events like chess and sudoku!

The event will end with our signature event - Aashayein!

All in all we promise a super duper fun event!!!

To make sure patients who stay in other parts of the country who do not want to miss their dialysis, a participation allowance is being given for early registrants that should cover flight tickets as well!

If you want to come and spend a few days in the city of Hyderabad also, you could use the allowance to cover your accommodation! Dialysis can be arranged at a NephroPlus centre at a reasonable price.

So, if you are on dialysis or know someone who is, please register today!

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... http://www.kamaldshah.com/2015/01/announcing-indias-first-ever-dialysis.html


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Wednesday, 21 January 2015 05:59

What’s it like to be on dialysis?

Written by Greg Collette
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What is it like to be on dialysis?

In my last post I asked for your help in preparing a video for people who have just been told they need dialysis.  It’s a scary time and the first thing most people look for is information they can trust. Who better to provide that information that the BigD community?

I was asked for the video by MaryAnn & Rajiv in Bangalore, India.  They are putting together a range of videos covering dialysis and transplantation.  The video I have prepared has a short introduction then a series of 1 – 2 minute interviews where we asked a broad cross-section of people on dialysis four questions:

  1. How did you feel when you found out that you had to go on dialysis?
  2. How did you feel after you has been on for a few weeks?
  3. How long have you been dialysing
  4. How do you feel now about life on dialysis?

In the Indian video, the interviews are shown together.  But for the BigD blog, I have linked them as separate files, that you can pick and choose as the fancy takes you.

We videoed the interviews using an iPhone 5.  Some people were on dialysis, others not.  Most are in English, though there are also Hindi and Italian versions at the bottom of the page.

Obviously, if you want to make a video (in any language), please do!  Send the file to me via email (or Dropbox or whatever) and I will process it for YouTube add it to the collection.

So, for your viewing and listening pleasure, here is our first BigD Voice-of the-People video post.

... https://bigdandme.wordpress.com/2015/01/21/whats-it-like-to-be-on-dialysis/


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Thursday, 15 January 2015 07:40

Mumbai Diary

Written by Kamal Shah
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I have fond memories of this city. My aunt stayed here until a few years back. As a kid, I have spent many summer days here. The idlis at Sukh Sagar, the pizzas at New Yorkers, my aunt's cooking itself was no less a treat! Then we had a summer camp here as well where cousins from all over gathered and had a blast for a couple of weeks. I remember the drive to Kalambole where we had our fill of water melons from the road side shops that stocked mounds and mounds of this delicious fruit and we kids along with the adults trooped into a shop and finished off 15-20 water melons in one stroke!

Going back to this city is always enjoyable with all these memories!

NephroPlus@Borivali

We partnered with the renowned Dr. Umesh Khanna (well-known for his landmark paper "The Economics of Dialysis in India" among several other accomplishments - but I have always associated him with this paper only!) to run his massive dialysis centre at the Lancelot Compound in Borivali West.

I had a great interaction with all the guests (patients, for those uninitiated in NephroPlus jargon!) there. They all seemed genuinely happy. Dialysis, in some ways, can be a humbling normaliser. Whether your nett worth is a crore or a thousand, you use the same needles, the same machine and the same technique to get your body cleansed.

Annual Patient Picnic of the Mumbai Kidney Foundation

The next day was Sunday and the Annual Patient Picnic of the Mumbai Kidney Foundation (MKF). This was truly an amazing event. It was held at Borivali National Park. Dr. Umesh Khanna (who founded MKF) along with his wife, Dr. Molina Khanna, who happens to be a gastroenterologist were exemplary hosts, literally running from here to there to ensure that every patient and family member had a great time. Handling the mammoth crowd of more than 300 people was quite a task.

This reminded me of NephroPlus' very own Aashayein event. Patients need such outings and events to meet fellow-patients and have a day of complete fun!

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With Dr. Umesh Khanna


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Dialysis Patient singing 'Ek Chatur Naar'


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With the NephroPlus team


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With Dr. Umesh Khanna and Dr. Molina Khanna (second from left)


Attitude of the patients 

One thing I noticed was that most patients in Mumbai - and I met and saw quite a few during this trip - were generally happy despite the burden of a chronic disease. Few complained. They were all having a gala time. One patient sang the whole 'Ek Chatur Naar' song from the film Padosan while the others egged him on. It was a truly pleasurable sight!

The other patients also were very strong-willed and cheerful. They looked determined not to let the disease get the better of them.

Vada Pav

I asked one of our techs at NephroPlus, Mumbai where we got great Vada Pav, the snack, Mumbai is world-famous for and he took my colleagues and me to a 'bandi' called Mangesh Vada Pav. The crowd there was insane. People were literally falling over one another to get their hands on a Vada Pav. I have no idea how the guys there managed the stall. It required some deft pushing and pulling by the tech and my other colleagues to get our hands on some Vada Pavs. They were really awesome!

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My cousin, Deep

I got to know of Deep from another uncle of mine who stays in the US. I had no clue that my own cousin was on dialysis. Deep has a condition called Neurogenic Bladder which causes the kidneys to get damaged and lose function. He has been on dialysis for a couple of years now. He is only 23. I can completely relate to Deep because I was also diagnosed at 21. When I came back from Mumbai, I got Deep back with me and both of us spent some quality time together. Here are some pics from Deep's visit to Hyderabad.

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... http://www.kamaldshah.com/2015/01/mumbai-diary.html


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Wednesday, 14 January 2015 09:08

Jain Cosmology revisited

Written by Kamal Shah
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(Disclaimer: Read only if you're Jain. You may not get this post otherwise.)

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I have always wondered about how Jain cosmology was so wrong. Everything else I have read in the Jain scriptures seemed to be in consonance with science. Why then was there so much difference between Jain cosmology and what modern science says about the universe?

I have been searching for explanations for this difference. I never found any. Then yesterday, I suddenly found this article by Amit Jain titled "A Reevaluation Of Space And Time Descriptions In Jain Annals". This article offers a series of very rational hypotheses on the Jina's teachings on cosmology and how these could correlate to what modern science says.

The trouble is in the misinterpretation of the Jina's teachings. Over-enthusiastic sadhus down the ages have corrupted these teachings and many other teachings of the Jinas so much that the current form of the religion is very, very different from what the Jinas preached.

Coming back to the article, the author provides a good summary in the following lines:

This paper is an attempt to introspect the annals and introduce an alternate model that is based on the Sutras of Jina, and is also in sync with modern science and its findings. This model tends to convey that the current interpretation of Jain Sutras on cosmology is wrong on below points:
  • Interpreting Bharat-Kshetra[1] as India is wrong and not in sync with Jain annals.
  • Interpreting Jambudvipa[2] with Earth is wrong and not in sync with Jain annals.
This paper tends to conclude that
  • Jambudvipa is actually this entire multiverse of which our planet earth is a part off.
  • There may exist two suns and moons, but the second set is not in our part of the universe.
  • Mt Meru is the central axis of cosmos on which our multi-verse revolves around and thus is not on planet earth.
  • The revolving of our part of world (Bharat-Kshetra) around Mt Meru leads to Kala-Chakra[3].
  • This universe is revolving in nature that leads to self-repeating epochs.
When you think about it, this makes a lot of sense. For those who are well-versed with the Jain version of the universe and the scientific version, these hypotheses make a lot of sense. Of course, none of this can be proved. Who can prove such things though? But this did put my mind at ease.

Namo jinanam!

... http://www.kamaldshah.com/2015/01/jain-cosmology-revisited.html

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