Before Illness Begins: A Real Conversation on Preventive Health (Dr. Sathish Devadoss & Dr. Hema Sathish)
Why India Needs Preventive Healthcare NOW! | Dr. Sathish Devadoss | Dr. Hema Sathish | Cureka
Table of Contents:
1. What do you think preventive health care would mean?
2. Prevention can help you from a fall or from an injury
3. Tertiary prevention
4. Prevention care for stroke
5. Prevention care for pressure sores/bed sores
6. Misconceptions about preventive health care
7. Social well-being
8. Better way to prevent stress
9. Health check-ups for men and women
10. Which is stopping us from taking first step of action in preventive care?
11. How you can have a good lifestyle and prevent illness?
12. If something is labelled organic, then it is healthy
13. Skipping meals helps in weight loss
The Real Conversation:
Dr. Hema Sathish: You know, in India, 80% of the diseases can be prevented. But nobody works towards the preventing of a disease. And we have worked a lot towards the prevention of diseases.
And that's where we play a role. I'm Dr. Hema Sathish, the founder of Cureka. And here we have Dr. Sathish Devadoss, the co-founder of Cureka.
Hello.
Dr. Sathish Devadoss: Hello. So Cureka is a preventive health platform which is accessible for everybody.
And our goal is to prevent diseases and not to complicate things. And let it go for a later stage.
Dr. Hema Sathish: So we are trying to flip the 80% of the diseases which can be prevented instead of being cured.
Cure is the first thing which we think about. So when a disease comes, we run to the doctor. But why not take care before we even get the disease? So what do you think preventive health care would mean?
What do you think preventive health care would mean?
Dr. Sathish Devadoss: So absolutely, preventive health care actually means that you can prevent diseases before they occur. So that is the most important thing. This can be done by doing regular screening, leading a healthy lifestyle, detecting diseases before they become full blown. So all these can lead to better treatment of these patients who have any diseases.
Dr. Hema Sathish: Yeah, we should include avoidance of injuries as we age, not only as we age, but at times, you know, you're very active and you're doing something and you're risking it a little more. Then that time also prevention can help you from a fall or from an injury, right?
Prevention can help you from a fall or from an injury
Dr. Sathish Devadoss: Exactly. In the young sports person, the sports person should do proper warm up, proper training so that he can or she can prevent injuries. And then for the elderly people who have frequent predisposition for falls, they should do some core exercises, strengthening, as well as see any risks of falls which can lead to fractures or conditions which can be very painful. So preventive health care does not mean only doing blood tests. It means that a whole gamut of things right from preventing injuries to preventing illnesses.
Dr. Hema Sathish: Well, preventive health care is also divided as a primary prevention, then there's a secondary prevention, and then there's a tertiary prevention also. So would you like to talk about the tertiary prevention which comes in? Because, you know, many a times what happens, we believe that, oh, I've become a diabetic, so I should take lesser of this, that and all. We are aware of it, but nevertheless, you know, we do not want to implement it many a times because we don't probably think of the complications still coming soon.
But what else can, I mean, there are many other diseases like that, right?
Tertiary prevention
Dr. Sathish Devadoss: So tertiary prevention first is to diagnose the condition correctly, then make sure the condition is under control. In fact, if somebody is having diabetes or hypertension or any other non-communicable disease, you have to make sure that the condition is under control. So this will prevent this disease or this condition which may lead to further complications.
So preventing the complications is what is called as the tertiary prevention. So it's very important that in these conditions, we need to make sure that the person suffering from this disease has his regular checkups, make sure he or she has a regular healthy lifestyle, and make sure he or she will prevent these complications which can occur and which can make things very, very, very bad for them in the future.
Dr. Hema Sathish: Well, you know, when you talk about diseases, we are talking about some diseases which you can help like prevent or help yourself from making it worse. But then there are some conditions very sadly that, you know, sometimes it's very debilitating. So if you have had a stroke and they are on bed for a long time. So preventive health care helps there also, right? But there is a lot of prevention over there also.
So what can be done when something like that comes up?
Prevention care for stroke
Dr. Sathish Devadoss: So in a person who is bedridden, it's very important that all his or her joints are mobilized. If they lie on bed for a long time, there's an increased risk of deep vein thrombosis, which means that the blood can clot in the veins in their legs. So you need to prevent this.
It's a very serious complication. If that blood clot moves out from there, it can go to the heart or brain and become life threatening. So you need to prevent it.
How do you prevent it? By regularly moving the joints, by regularly moving the foot and ankle, and also by using preventive stalking devices, which can also help in reducing the chance of deep vein thrombosis. Similarly, patients who are bedridden for a long time, they can also get what is called as bed sores, which are pressure sores. So if they lie down in the same position due to pain or due to inability to move for a long time, it is mandatory for the caregivers, especially at their home, to make sure that they move the patient either to the sides or to make them change their position so that there is no pressure sore developing.
If a bed sore or a pressure sore develops, it becomes a really big problem. It can get infected and the person who is having this debilitating condition can lose a lot of protein, nutrition through these wounds and it's going to be a pathetic life after that.
Dr. Hema Sathish: See, well, even if you have a condition, it's not necessary that, you know, you succumb to it and then you think that that's the end of the road.
No. So how do you, you know, everybody is bold, they try to fight back. But at times, you know, you miss out, like you're not having your right proteins, you're not doing your proper exercises, you're not using the preventive measures which you're supposed to use.
So if you can tell something on those, like what are things which they can use and what we could curate for them to prevent, you know, getting worse from what they are.
Preventive care for pressure sores/bed sores
Dr. Sathish Devadoss: So in debilitated people who are on their bed for a long time, so it's very important first to prevent pressure sores, that you can do so by using these air beds and also changing the position of the person very often. Encourage them to walk, do adequate physiotherapy, you can request a physiotherapist to come and do physiotherapy and make them walk.
So that is very important. And second thing is the kind of nutrition they are getting. Because most of the time to avoid going to the toilet, these people will start taking less food and less fluid.
So this becomes a problem and they start taking less food and fluid just to avoid going to the toilet. So there the nutrition comes down and when they become weak, they can get any other diseases like pneumonia, they can get urinary infections. All these problems can come if you are debilitated and your loss of nutrition also.
So here to prevent all this, proper nutritional guidance is required for people in the debilitated state.
Dr. Hema Sathish: So we've spoken quite a bit about preventive health care and quite a few angles which people don't think in. So that's something which we have spoken about.
But I was thinking about, you know, what are the misconceptions about preventive health care? Because when you talk preventive health care, they say, I mean, everybody, the first thing which pops in their mind is, you know, taking multivitamins. That's fair enough. It's good enough also.
And then if they are a little more advanced in their thinking, then they think about immunization. But I have yet to meet somebody who can think about something more than that or thinking about intervening in conditions where they've already developed a problem and how to prevent further and all those things. So there are a lot of misconceptions about this, right?
Misconceptions about preventive healthcare
Dr. Sathish Devadoss: So the first misconception I would say is that preventive health care is for elderly, is the biggest misconception.
So preventive health care starts from as you're a child, you know, because many older women they get something called osteoporosis, which is weakening and thinning of bones. This bone is like a bank. And you have to develop the bone stock with your deposits of calcium and protein and minerals.
Dr. Hema Sathish: And that's the orthopedic surgeons talking.
Dr. Sathish Devadoss: From a very, very young age, right from your second decade onwards, you need to build up these bones. So it's very, very important to right from young age, your preventive health starts.
Similarly, as we have told earlier, preventing injuries in youngsters also is very important. And once someone gets a disease, it's very, very important to not to make this into further complications. So you need to prevent the progress of this disease.
So it's very important that it doesn't go into other complications of the disease. So the first misconception is, I think, the age.
Dr. Hema Sathish: OK, well, I'd like to highlight one more misconception along with this is, you know, social well-being.
Don't you think social well-being is very underestimated? In today's world, people just feel, you know, social well-being is being on social media. Social well-being is how you interact with people whom you are with or around us, you know. So that's very important is what I think.
I hope you also agree with it.
Social wellbeing
Dr. Sathish Devadoss: Definitely. Social well-being is today very important because people are always buried in their cell phones or their computers. It's very important for them to interact with other people. Please carry on with your thoughts on social well-being.
Dr. Hema Sathish: And not only that, mental health. So it's when you talk about holistic prevention, then these are something which we have to bear in mind. So it's not only about, you know, avoiding a fall or avoiding some other problems which could come in the future, which you can foresee or think. But this social well-being is also mandated because that's like overall development of you.
And that is going to, you know, keep you fit quite a bit because mental health is very, very important. You must be also having patients, right, who they're not mentally well. Then they come up with a lot of physical problems also.
Dr. Sathish Devadoss: We call them psychosomatic illnesses where there is an underlying mental health issue. I won't say they are crazy, but it just says that due to stress, these pains also get amplified. Most commonly, this neck pain and low back aches are very common areas of the psychosomatic disorders where nearly 25% of the pain they express is due to stress.
Dr. Hema Sathish: But I think when they're stressed, they're trying to hold your muscles also tightly. If you have observed, like when you're very stressed, you know, all your muscles are also held very tightly. So maybe that is because of that also the pain can reflect. Yeah, there is a lot of chemical changes. Yeah, there is a lot of chemical changes inside the body. And then apart from this, you tend to feel it is amplified because obviously your focus is on something which is going to make you feel better.
So probably when you get some attention, you feel nice. So there's nothing wrong in it. But nevertheless, that is one aspect which you can avoid. So prevention should be in that aspect also. It is just one of the aspects I thought.
Better way to prevent stress
Dr. Sathish Devadoss: So what do you think is a better way to prevent this kind of stress?
Dr. Hema Sathish: Well, social well-being means having friends. I feel vitamin F is very, very important. That is friends. So you should have friends always any given point of time.
I think parents also should encourage because today's children, it's very difficult as you and me also we are seeing like kids find it very difficult to make good friends, you know. And so as parents, we should also encourage that, I guess. So I think I've done a little bit of that with the children and when they have their friends and when they want to have the time with their friends, I do demarcate the time and say, no, no, no, you should be with your friends at this point of time so that, you know, in future they have somebody to fall back at, somebody to talk to, because even if parents are there, there are some things they don't share with us or we don't share with our parents either. So, you know, that is.
Dr. Sathish Devadoss: So I think meditation and yoga can be a big stress buster and definitely if they do these two, I feel in the long run, their usage of medications and it can prevent the progress of the disease. So I think these meditation and yoga are great exercises for the brain and for the mind, so which will prevent stress.
Dr. Hema Sathish: So I would like to know if you would say like if somebody has to keep fit, so you choose yoga or gym, what would you choose? I mean, you have to, of course, tell me the reason for both of them.
Dr. Sathish Devadoss: People over the age of 50 will definitely, people, young people go to gym, they pump iron and things like that. But actually people above the age of 50, they need to go to the gym because after 50, they develop something called a sarcopenia, which means there's muscle wasting.
Dr. Hema Sathish: I think that's very much overlooked, right? Yes. People don't realize it. It's just age and it's bound to happen. So this is also one aspect of prevention, which you can really look into.
Dr. Sathish Devadoss: So to avoid sarcopenia, because sarcopenia in turn will lead to weakness of bones, in turn it can lead to frequent falls, in turn it can lead to fractures. So this is a very vicious cycle. So again, people above the age of 50, I would recommend them to do resistance training, that is lifting weights and going to the gym.
Dr. Hema Sathish: Yeah, but a word of caution, right? They shouldn't do it suddenly and too much of weight is also not good. Dr. Sathish Devadoss: Under a proper trainer guidance.
Health checkups for men and women
Dr. Hema Sathish: Well, health checkups are another one thing, right? Everybody is now aware and they do their health checkups regularly. And I think all many companies also promote this a lot more and they help their employees do their blood tests and I mean, regular checkups and everything. So in your, this thing, I mean, generally, like how you see observe in the hospital or what is set in the hospital, would you like to speak about how often the health check should be done? And there are some special checks which should be done specifically for men and women. So a little bit on that maybe.
Dr. Sathish Devadoss: Right. So anybody over the age of 40 or 45, I believe should have a health checkup every year.
Okay. Basically, we can see that most of our people are now having a very sedentary lifestyle. You know, sitting is new smoking, you know. So if you're sitting for a long time, your body becomes completely not doing anything and you're going to have, so it's a new smoking is sitting. So you need to have a healthy lifestyle. So for that, so to make sure that you do one health checkup every year.
For men and women, maybe slightly different. Women should have, are more prone for cancers of the breast and cancers of the cervix. So women should have probably a pap smear also on a regular basis.
And regular self-examination of the breast by women can be done by themselves. But apart from that, they can have a mammogram or less invasive is an ultrasound mammogram, which can also detect early stages of breast cancer, especially if they have cancers in the family. So it's very important for women to check these two also.
And preferably once a year is a very good thing. Apart from that, women, as we discussed earlier, are more prone for osteoporosis. So they should, after 50, they should probably have a DEXA scan, which is a bone scan, which will tell about the density of the bone.
So that will help us to know whether the bone is weak or not. And then if it is weak, then we can ask them to undergo some treatment to make the bone stronger. So if it is very weak, then there's a very, very high risk of fractures.
And osteoporosis is a silent killer. The first symptom of osteoporosis is a fracture. So there is no other symptom. That's very bad. Very bad. So and very painful. Yeah, it's very painful.
Dr. Hema Sathish: Bone takes a long time to heal, especially if it is having osteoporosis.
Dr. Sathish Devadoss: Exactly. So DEXA is a five-minute test every year for every woman should be done after 50, after menopause.
Dr. Hema Sathish: And some things about men also.
Dr. Sathish Devadoss: Men should have a prostate check regularly after 50. They should have frequent abdominal scans to make sure the prostate is not enlarged. And also a surgeon can check whether the prostate is enlarged or not. And there are some blood tests which can detect prostate cancer, which are very unique with men.
Prostate is a gland which is just below the urinary bladder, which can cause cancer. And men can get this. And above 50 also, if possible, men can also undergo colon endoscope or a colonoscope, which will also show if there is any intestinal cancer. So that can happen once in two or three years.
Dr. Hema Sathish: That's a lot of information. I have now slipped into the preventive health care zone and you are in the tertiary health care zone more. So I would like to know, what would you advise? I mean, what is more cost saving, preventive health or tertiary health care? Dr. Sathish Devadoss: Definitely preventive health. Definitely preventive health. Tertiary health care is expensive. It's painful and it can lead to many complications. So definitely if you can avoid all these things at a very early stage, you are going to save money, save a lot of pain.
Dr. Hema Sathish: Smart living. So I think like investing in shares or in your better future in terms of financial status, I think we should invest in health also, right?
Dr. Sathish Devadoss: So health is wealth as been put forward early. So health is wealth and definitely you should invest in your health to make sure your body can run long life without major issues. So it's very important that you invest in your health.
Dr. Hema Sathish: And I've also seen, you know, what happens is like you're very healthy, but then suddenly you develop a problem. Then it does pull you down a few steps. And then how much ever you try to pull yourself back, then there is a little bit of a constraint towards many things. So at least if not many, few things. So I think that time also prevention takes its role and pulls you back again. Like you can do a lot of exercises, physiotherapy.
There are so many equipments available. There are so many ways to take care of yourself. So and as I always believe, you know, whatever happens, you have the right to live it really well and you make the choice.
So that's very true. Well, if you have to see in the Western world, preventive health care is so, so much seeked for. And I think people, I think it's the health care system which works like that, right? Because for them to avail health care, it's very expensive.
And so they want to trade. They don't want to get into that and try to help themselves as much as possible. Try to keep themselves, you know, I mean, they do not want support from others. So they're very, very independent that way also. So what is the biggest tumble block or the roadblocks which we have in India, which is, you know, stopping us from taking preventive health care as the first step of action?
Which is stopping us from taking first step of action?
Dr. Sathish Devadoss: Correct. So first, I would say preventive health care, there is no awareness in our country. Yeah, that's true. So lack of awareness is the major factor, the major stumble block. When we say that you should do regular checkups, you should meet your doctors, get adequate awareness of your disorders.
If any familial disorder is there, you have to do things. People think that hospitals and doctors are making money, but it's not so. It's your investment in your own health, which is going to take you long innings in your future.
So awareness, I think, is the most important part of preventive health care. The second thing is, socio-economically, people may not be very well off to do these tests on a regular basis. So I think government has come in and they do have master health checkup available in the government hospital also, especially in Tamil Nadu.
And I'm sure people can avail these facilities for no cost at all, with the good quality nowadays in all the government hospitals also. So I think that, again, should not be a barrier. So my only point is here, awareness. People should be more aware that health needs to be checked regularly and you need to do preventive checkups regularly so that you would avoid getting diseases or the progress of the disease. So you see, even for our cars and two wheelers, every two or three months, you're servicing it. Or when that adequate kilometer runs, you're servicing it. So when even mechanical vehicles need service, your body, which is like a fantastic vehicle developed by God, needs servicing regularly. So that is your preventive health checkup.
Dr. Hema Sathish: That's a nice way to put it, or a very cruel way to put it, I guess.
Dr. Sathish Devadoss: Being an accomplished dermatologist, Dr. Hema, you have been asking me a lot of questions about orthopedics and other things. So how do you think the skin problems can be prevented?
Dr. Hema Sathish: Well, to begin with, my first always, I always keep saying this, don't overdo things. You know, the youngsters look at all the reels, look at everything, and then they want to apply whatever comes to their mind and whatever they feel is right for them.
So don't, you know, choose without having the correct knowledge about things. So that would avoid a lot of complications and a lot of problems on the whole. And then some diseases which are like autoimmune, which I see a lot of them now, and because of sun-related problems, although there are some diseases or not, so those you can do by sun avoidance or taking care of yourself well without, you know, getting yourself like burnt out in the sun.
Sun exposure is necessary for vitamin D, but nevertheless, you know, you needn't go and blaze it out in the sun. And then apart from that, this autoimmune diseases, which I see quite often is because the younger generation is following a lot of fancy things, and they do not take up things which are actually very easily available. That is, you know, the natural food which is available, especially in India, abundance of that.
But I think that is avoided a lot more, and the youngsters are looking at more fancier things to eat.
Dr. Sathish Devadoss: Processed food and processed sugars.
Dr. Hema Sathish: Yes. So if that can be avoided, there's a whole load of skin problems which can be avoided.
Dr. Sathish Devadoss: So according to you, can you give some tips to our listeners, how you can have a good lifestyle and prevent illnesses?
How you can have a good lifestyle and prevent illness?
Dr. Hema Sathish: This is a basic thing. Stick to timings more, like, you know, having a schedule is out of fashion nowadays, you know, saying that I was up late in the night.
So I woke up late today. I'm just going to sleep extra. All that sounds good. It's fine once in a while. But then I would say that have a schedule most of the times.
Dr. Sathish Devadoss: So the circadian rhythm of the body.
Dr. Hema Sathish: The circadian rhythm of the body is very, very important because, you know, that sets the clock for so many hormone secretions, so much of your cell rejuvenation and so much of your mental health to be, you know, functioning well. So with all that, that would help a lot. And then apart from that, diet.
Diet is the biggest thing. Diet is something I would point blank, if you have to say, try to stick to the local food which is available and try to listen to your mom who says eat healthy or eat or your grandmother's diet would be the best thing to follow is what I would like to say. And with all that, I think it should be.
And then physical activity. Schools nowadays don't give any physical activity. So there are many conditions like obesity leads to a trail of diseases. And that is thanks to no physical activities in the school. So school is not only for studying, it's for overall development. So that has to be also looked into. And there should be some kind of activity. And I feel that young kids, you know, they all say, yeah, I joined the gym. So I always tell them, don't join the gym.
Play, play something because, you know, there should be some games. Overall development. Overall development. So that mentally also helps, physically also helps. And then at the same time, you know, you're playing with somebody else. You're interacting with somebody else. You're making friends. So social, your well-being is also better. Your social connect is going to improve a lot more.
So there are so many things if you just live a simple life.
Dr. Sathish Devadoss: I think adding to your points for a youngster, for a young adult, I think avoidance of alcohol. And total abstinence from smoking. I think these are two important lifestyle modifications they have to keep in mind to prevent illnesses.
Dr. Hema Sathish: And vaping is worse than smoking. So that's also not acceptable.
Dr. Sathish Devadoss: So these kind of ill habits, I think should be avoided by the younger generation.
Dr. Hema Sathish: And they're going to hate us for this. There are some myths.
So I'll ask you now. I'm young, so I can recover real fast?
Dr. Sathish Devadoss: If you have the right nutrition and if you have the right kind of treatment, you can recover. That is not true always. It's not true always.
Dr. Hema Sathish: Well, healthy food is expensive.
Dr. Sathish Devadoss: Need not be. We have now so many health stores, even in villages. Now you can get all the cereals, millets. All these are very healthy. I don't think you're talking about cereals. No, not the boxed cereals.
No, I mean to say the millets and this dal and other things so that it's definitely not expensive. If you eat the right kind of food, it's definitely not expensive.
Dr. Hema Sathish: And the local fruits are absolutely great all the time.
Dr. Sathish Devadoss: Fruits and vegetables definitely are very good.
Dr. Hema Sathish: Gym is equal to good health minus ignore sleep, food, mental health, everything. True or false?
Dr. Sathish Devadoss: Definitely the other parts should be a plus. Good sleep, good diet should be a must for everybody's life. Gym can be an added benefit, like I told in the elder age group as well as the younger age group.
Dr. Hema Sathish: I don't feel sick, so I'm healthy.
Dr. Sathish Devadoss: Need not be. Like I told, there are a lot of silent killers. So you need to check regularly your heart, your bones , your other functions of your body like liver.
One silent killer is a fatty liver, which can go on to become cirrhosis. So there also you may not know the symptoms till it goes to the third stage.
Dr. Hema Sathish: And it's quite common and people think it's just fine. Oh, I have a fatty liver. So I don't think they realize the significance.
Dr. Sathish Devadoss: It's a very significant disease and the burden for the country right now.
Dr. Hema Sathish: Multivitamins can replace meals.
Dr. Sathish Devadoss: Definitely not. You need a balanced diet. Multivitamins are part of it. The food itself will contain a lot of vitamins. Multivitamins can be supplements. When people like elderly people cannot digest many foods, cannot be able to absorb those vitamins, there can be supplements. But it cannot be a replacement.
Dr. Hema Sathish: And I think fast paced lifestyle also. At times you're not able to catch up with all your dietary needs. Then supplements do help, right? Correct. Only overweight people have lifestyle diseases.
Dr. Sathish Devadoss: I have seen many young and thin individuals who are probably famous movie star also, was working out in a gym and died of a heart attack. So it's a myth. So anybody and everybody should have regular checkups. It's not only the obese, it can be any healthy looking person also. Unless you check your body, you will not know the disease.
Dr. Hema Sathish: And there was once I was reading an article like, you know, somebody died really young. He was very fit and he used to keep track of everything about himself and lived a very lovely life. But stress was very high and sleep was very less. So yes, that can also be a killer, right? Yeah.
Dr. Sathish Devadoss: These are lifestyle disorders.
Dr. Hema Sathish: So these also come under lifestyle disorders. So thin doesn't mean fit. Sweating equal to fat loss.
Dr. Sathish Devadoss: That you should answer.
Dr. Hema Sathish: No, not at all. Sweating. I mean, sweating is from the glands, which are way above the fat cells. So, you know, you don't sweat out fat. I wish I could actually, but then it doesn't happen. That's not true. Many people believe that, you know, when I'm ready, I'll start or when the time comes or the necessity comes, I'll start taking care of myself.
So what's your take on that?
Dr. Sathish Devadoss: So the necessity is there from your childhood. You need to take care of your body, your mind right from childhood. So there is no time expiry date on your body or anything. So you have to definitely start at a young age and regular checkups with your physician, even in school, even in the colleges. All this will definitely help. Especially we see