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November 6, 2019 By Dr. Viral Thakkar Leave a Comment

Stroke: A Few Untouched Aspects

stroke

Stroke is the sudden death of some brain cells due to lack of oxygen when the blood flow to the brain is lost by blockage or rupture of an artery to the brain. According to the WHO, it is the second leading cause of death and the third leading cause of disability. Stroke is also a leading cause of dementia and depression. For commonly known causes of stroke, please refer to the article “Stroke: Straight Dive or Pavilion” published earlier. While you might have read a number of reasons which lead to stroke, this article focuses on the importance of emotional health to prevent stroke.

 There Are 2 Main Types of Stroke  

  1. Hemorrhagic Stroke: is caused by bleeding in the brain due to a weak spot in the wall of the vessel, which can cause an aneurysm (bulging of the vessel wall). The vessels can also be weakened by chronic or very high blood pressure and break from force. When the vessel breaks, blood leaks into surrounding tissue, and the brain doesn’t get the oxygen and nutrients it needs.
  2. Ischemic Stroke: results from blocked arteries, which often occur from cholesterol build-up, called plaque. Plaques on the inside of the vessel can be fragile when blood flows past, causing the plaque to lift.  But in the blood vessel, when a plaque lifts-up and the body tries to heal it, like it would scab on your arm, it makes a clot where that plaque lifted up, which blocks blood flow and can lead to ischemic stroke.

The human body is magical. When the mind perceives a threat or stress, the body releases cortisol and adrenaline to cope with it. These hormones impact the homeostasis of the body; the other parameters get deranged and affect the healing processes of the body. Now, if your personality is to take constant stress, cortisol and level of other stress hormones will be high to ensure the body deals with stress. This could cause retention of salt which might increase blood pressure. Stress also causes an increase in blood sugar, which means the vessels can’t dilate or contract to better control blood flow. Increased cortisol is also known to disrupt sleep cycles leading to fatigue.

Anyone Can Be At Risk…

…for many reasons, not just stress. Sometimes, it just how your body responds.

While there is no concrete reason to state that positive emotions, a stress-free life or a balanced psychological state will not lead to stroke. However, there are numerous research studies to indicate that there might be a relationship between negative emotions, stress & stroke. In my practice, I have usually seen stressed people holding negative emotions fall prey to issues like stress, heart ailments, etc.  A University of Michigan study found that men who were more physiologically reactive to stress were 72% more likely to suffer a stroke.

Regardless of how your life or your job is, if you feel you are stressed, you most probably are.

If you’re still unsure, ask yourself these questions:

  • Does your significant other tell you, you seem stressed?
  • You tend to pick up fights and arguments with your family and co-workers more than normal?
  • You resort to alcohol, drugs, smoking to alleviate stress?
  • Do you find less joy in things that normally make you happy?
  • Do you find it difficult to fall or stay asleep compared to normal?
  • You don’t like to get up in the morning, especially on days you know you will come across stress causing situations

If the answer to the above is yes, then it’s time for you to work on yourself. Contemplate on the reason, give attention to the little things in life… It is the little things which lead to bigger changes! Some attitude changes like acceptance and forgiveness make a lot of difference!

Quick tip: Whenever you feel stress, start taking deep breaths. Mentally count till 5 & inhale, count another 5 and exhale. Make it as slow and steady as possible. Taking in more oxygen allows more oxygen to be available to the brain tissues. Some research suggests that deep breathing helps to rehabilitate the brain after a stroke. This style of breathing also helps to relax and calm the mind and whole being.

While everyone faces issues in life, it is the ability to cope with it, be in sync with one’s body which determines health!

#BeTheForce

October 31, 2019 By GOQii Leave a Comment

The New Age Health Horror of Diabesity

DiabesityWhen someone says “horror”, what do you imagine? Definitely nothing pleasant but something extremely scary, right? Do you picture ghosts and demons? If your perception of horror is limited to only supernatural occurrences, you might want to take a big step back. While supernatural entities are subjective, health issues are very much real and their stats are horrifying to say the least.

Recently, we came across a study titled ‘Finding a Policy Solution to India’s Diabetes Epidemic‘ by Karen Siegel, K. M  Venkat Narayan and Sanjay Kinra. The study indicated that ‘In India, 35 million people have diabetes—a number expected to more than double by 2025, disproportionately affecting working-age people’. That means over 70 million people. Isn’t that scary?

Diabesity, which is a combination of Diabetes and Obesity, is even worse! Can you picture it? Obesity is a key risk factor for diabetes. India has the world’s largest number of people with Impaired Glucose Tolerance (IGT) and Impaired Fasting Glucose (IFG), which are the precursors for diabetes. Obesity and IGT are mostly found in younger populations.

Major Causes Leading to Diabesity

  1. Globalization: facilitates access to various pre-packaged and processed foods. In fact, there is minimal physical activity as we have one touch access to almost everything! Surely, we are growing economically but at the cost of our health.
  2. Nutrition Transition: There is a major shift observed in the meal patterns of Indians today. People are turning more towards western foods, foods that are pre-packaged, ready to eat foods, high in calories, sugar, aerated drinks, hydrogenated fats over the simple traditional food which are high in vitamins, minerals, fiber and other essential nutrients.
  3. Higher Percentage of Abdominal Fat: Abdominal obesity is the key factor of insulin resistance and development of diabetes.
  4. Malnutrition During Pregnancy: Because of the co-existence of underweight and overweight, children are often born underweight and adapted to a low-nutrition environment. Low-birth weight infants are more susceptible than those of normal birth weight to obesity and diabetes, especially when raised in an Obesogenic environment.
  5. Lifestyle: Most people today lead sedentary lifestyles devoid of much movement. Even at work we’re glued to our desks and laptops. This accounts to minimal physical activity. At the same time, the stress factor is the maximum with respect to targets/goals associated with work, family and social circles.

How To Keep It At Bay

Keeping Diabesity at bay actually involves 3 very simple and basic lifestyle modifications:

  1. Make Healthy Food Choices: Choose whole grains and its products over refined ones. Incorporate more fruits and veggies daily. Opt for products less in sugars, fats and high in fiber. Make a habit of reading nutritional labels before buying a product. Do not forget “MODERATION IS THE KEY”.
  2. Exercise: Make it a point to exercise on a regular basis. Exercising will not only keep you active but also help reduce insulin resistance, improve cardio vascular strength, tone your muscles, and increase Basal Metabolic Rate (BMR). Exercising releases endorphins which is a feel good hormone that will also help you relieve stress(both physical and mental).
  3. Stress Management: Managing time and stress is essential to stop the release of the stress hormone Cortisol which makes you crave for foods that are high in carbs. All that you eat when stressed is stored in the body as fats, especially in the belly. Meditating regularly before going to bed, deep breathing during stressful moments, indulging in your hobbies, exercising, completing your work on time, etc. will help curb stress levels. It is not a single factor that would work but both.

If you want to learn about effective ways to manage obesity and diabetes, or want effective exercises to combat both, tune into GOQii Play and get live coaching from renowned experts you can even interact with.

We hope this article on Diabesity alarms you enough to make necessary lifestyle modifications before its too late! Stay healthy and #BeTheForce!

October 23, 2019 By Vickel Dubey Leave a Comment

Understanding Patient Behaviour Towards Digital Therapeutics

Are we, as patients ready to pay for an app which is intended for Therapeutic Purpose & Helping us manage our lifestyle better?

Digital Therapeutics

What a Patient Thinks

Ideation of this whole article took a shape while having a discussion with my father who is a Type 2 Diabetes patient. I was actually insisting him to install an app to better manage his lifestyle specifically the dietary recommendation (Since he is a banker by profession and also manages family business, day to day life is a complete mess) given by his doctor. Initially he was in agreement but when he asked me if there is any cost associated, I nodded yes. His decision changed immediately. According to him, he knows what to eat, what not to eat and on top of it, he is taking his medication (which he often forgets) so there is no need of a digital intervention. I tried to explain to him multiple times thereafter but all in vain. According to him, it’s just a waste of money.

Patient Compliance Behaviour: Medication vs Lifestyle Recommendation

This is the story of most Chronic Disease patients for whom managing their lifestyle is a crucial need. But it’s really sad to see the poor grades when it comes to be compliant of various lifestyle aspects. According to a study conducted among Indian diabetes patients, only 24.1% were aware and have been following self-blood glucose monitoring appropriately. Similarly, only 37% of the patients are adhered to the dietary prescription made by their physicians and only 35% follow up the physical exercise recommendations.

Why is it important to talk about “Patient’s Compliance Behaviour” before getting into the “Patient’s Commercial Behaviour”? The reason is that patients need a push specifically in case of chronic diseases because it’s all about care, whether it’s done by the patient himself or by a caregiver. In case of medication, the weightage is higher since it’s coming from doctors (with serious words) while in case of lifestyle, it comes as a recommendation rather than a prescription which defines the seriousness.

So, if a patient is serious enough about his disease condition and strictly follows the testing, medication and lifestyle modification, he/she doesn’t need any intervention, traditional or digital to manage his/her lifestyle but the statistics don’t reflect the same. Hence, it becomes important for patients who are not serious or moderately serious to keep engaged and motivated to adhere with the doctor’s recommendation via a push. Digital gives that push.

Now comes the commercial behaviour. There are hundreds of apps available in the market to manage your disease conditions. Some are freely available; some are coming complementary with the devices/treatment and for some, you have to lighten your pockets. Definitely the skewness is higher towards the free ones. Most of us preferred the free apps and uninstall any paid app when it asks for a payment after the trial period. But free apps have their own limitation and for better services/attributes or features, you have to pay. Same goes with the apps which are offering lifestyle management solutions for patients.

A Preliminary Investigation

To get a deeper understanding of patient’s behaviour, I conducted a small survey among diabetes patients. The survey designed on SurveyMonkey consists of 10 questions (5 open ended, 5 close ended) and shared on a few social media & chatting platforms such as Facebook, WhatsApp etc. The key questions are:

  1. Patient’s Name
  2. Age
  3. Is he a diabetic patient?
  4. If yes, is he using any online application to manage his Lifestyle?
  5. Name of the app he is currently using
  6. Is it a paid app?
  7. Approximate cost of the app.
  8. Will he pay for an app which promises to better manage lifestyle (in case the answer of Q6 is no)?
  9. If yes, what is the approximate cost he will pay?
  10. If no, why?

There were 43 responses received in total out of which 32 were diabetics. The outcome of the survey are as follows:

  • ~80% of the total respondents are within the age group of 30 to 60 years
  • Out of total diabetes patients, only 36% are using one or another app to manage their lifestyle
  • Majority of the patients are using MySugar (45%) followed by Apollo Sugar (27%), GOQii (18%) and Wellthy (9%).
  • Only 2 out of the total patients with diabetes who are using an app have paid some amount
  • The approximate cost which they have paid is ~INR 2500
  • 77% of the patients who are using an app (and answered no for Q6) are not ready to pay even if it provides a better solution, while only 23% are ready to pay.
  • The approximate cost which most of the patients feel comfortable to pay is INR 100-200 per month.
  • Free availability, YouTube videos, Advice by friends and family, waste of money etc. are some of the major reasons why people don’t want to pay for an app.

So, if we look closely, patients are quite ignorant when it comes to pay for an app. Reason, they consider it as a waste of money. This outlook needs to be changed. This perception needs to be changed. And it can only be changed when it comes as a prescription and not just a simple recommendation.

Conclusion

If a patient can spend ~INR 9,000 (from an analysis conducted by Lady Hardinge Medical College) annually for his diabetes treatment, he can definitely spend few hundred bucks to manage his lifestyle for better outcomes. But the patient also needs support from other industry stakeholders such as Pharma, Devices and payers so that the cost can be shared and patient will have to bear minimum cost burden.

April 7, 2019 By GOQii Leave a Comment

Stay Active, Stay Covered, Stay Stress Free | World Health Day

stay active stay covered stay healthyOne of the key points mentioned during GOQii’s annual event in December last year was that our current healthcare systems focus more on ‘sick care’ rather than preventive healthcare. Measures taken to ensure good health are often reactive as compared to proactive. The problem with this approach is that any precautions we take concerning health won’t be in place until it is too late.

We couldn’t stress more on why this mindset of ‘sick care’ is unyielding as opposed to leading a healthy lifestyle from the start. But as the case with most diseases and unpredictability of unfavorable circumstances, you can never be too prepared. With high healthcare costs and the trust in the healthcare systems decreasing, health insurance is certainly the need of the hour.

Universal Health Coverage

Everybody everywhere is entitled to health coverage that does not harm or put their finances at risk. Based on the WHO constitution of 1948, which declared health a fundamental human right and on the Health for All agenda set by the Alma Ata declaration in 1978, this year’s WHO theme for World Health Day is Universal Health Coverage. It is to ensure better health and protection for the poorest of the poor.

India and Universal Health Coverage

In India, approximately 62% deaths among men and 52% among women, occur due to non-communicable diseases. Due to the low utilization of the public health system, lack of effective management, awareness, and fragmentation of the healthcare services, families are forced to incur high expenditures leading to impoverishment and poverty on account of medical and hospitalization expenses. (source: https://www.pmjay.gov.in)

In an attempt to fulfill the vision of Health for All and Universal Health Coverage, the government conceived Ayushman Bharat, an initiative led by our Prime Minister Narendra Modi. Ayushman Bharat encompasses two complementary schemes, Health and Wellness Centers and National Health Protection Scheme. The Protection Scheme is envisaged to provide financial risk protection of Rs 5 lakh per family, per year to poor and vulnerable families arising out of primary and tertiary care hospitalization.

How GOQii Can Help

GOQii has always believed in enabling individuals to move from a reactive healthcare pattern to a more proactive one. The only way to achieve this is by rewarding good health. By using the data we collect, insurance companies lessen or alter the premiums paid for the life/health insurance they offer to their users, thereby cutting the cost for healthier users and altering the same for higher risk users. This helps the insurance companies and insurance holders make an informed choice of dealing with their health risks.

Through our partnership with Max Bupa, we offer a holistic health insurance offering called –‘Max Bupa GoActive’ to fulfil our customers’ daily health needs. GoActive is a digitally enabled health insurance plan that has been designed to give customers a 360-degree coverage including in-patient hospitalization and on-the-go access to OPD, diagnostics, personalized health coaching, second medical opinion, behavioral counseling and much more. The plan offers up to 20 per cent premium discount on achieving predetermined health scores and also offers benefits such as renewal discount of up to 20 per cent post achieving their health goals. We have also partnered with Swiss Re to provide underwriting assistance to Max Bupa wherein Swiss Re uses GOQii’s data to create relevant products and also build expertise to create risk assessment models for future.

In simple terms, get healthier, improve your health score and pay less premiums on your insurance cover.

To ensure good health and wellness, GOQii has organized a World Health Day Super Sale on the GOQii Health Store. Get amazing discounts on healthy products curated by our experts by using your GOQii Cash. Download the app now to avail its many benefits for free: www.goqii.com/app

#BeTheForce

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