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Doctors @ home

Doctors @ home
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First Published: Tue, Mar 13 2007. 12 16 AM IST
Updated: Tue, Mar 13 2007. 12 16 AM IST
It’s a visit that most of us like to postpone indefinitely. Lack of time, the cost factor, a small element of fear, whatever the reason, visiting the doctor just for a check-up is something we put off till it’s absolutely unavoidable.
This is where home diagnostic kits or do-it-yourself tests come in. In the West, the prohibitive cost of health care has led to a virtual explosion in health-test kits that you can use at home. The same range and variety may not be available in India, but there are still enough devices that can give you early warnings of an impending disease.
There are also some simple exercises that you can do at home and some excellent resources on the Internet that cost virtually nothing yet help you find out if you are in good physical condition.
Although there are some tests that are better left to a doctor (see box), medical practitioners are increasingly advising patients to be more proactive and do simple checks at home. Says Mumbai-based infertility specialist and health activist Dr Aniruddha Malpani, who runs the Health Education Library for People (an online health resource): “As far as everything else in your life is concerned, you make important decisions on your own. But when it comes to health, even relatively intelligent people stop thinking.”
Many of the kits mentioned here are available at the neighbourhood chemist’s and online (at really discounted rates). A word of warning, though, from Dr Anupam Sibal, director, medical services, Indraprastha Apollo Hospitals: “It is very important that the kits are manufactured by a reliable company and have cleared the mandatory quality-control standards. If the user is in doubt about the reliability of any home-use kit, he must consult a doctor prior to use. It is also crucial to carefully read the instructions to prevent any misuse or harm to the user.”
Weighing scales
A weighing scale is a must for every health-conscious home and tops the list of essential kits recommended by doctors. Fluctuating weight is one of the very first signs that things are not right with you. Dr Dipanjan Roy, medical epidemiologist, Centers for Disease Control and Prevention, suggests buying a weighing machine that calculates body fat too since scale measurement does not take that into account. Alternatively, you could get a simple pair of scales and download a Body Mass Index (BMI) calculator on your computer. If the BMI exceeds 25, you fall in the high-risk zone. The old-fashioned bath scales can be purchased for around Rs650 while digital scales can cost over Rs2,500.
Dr K.K. Aggarwal, president, Heart Care Foundation, suggests that a simple measuring tape might be better than weighing scales in assessing risks since where you carry your weight matters more than how much you weigh. As he points out, abdominal circumference is fast emerging as a very important indicator of cardiovascular risk as well as Type 2 diabetes. A high-risk waistline is more than 32 inches for women and 37 inches for men (Asian standards).
A digital thermometer is a must in every home, according to most doctors we spoke with, though Dr Malpani is a dissenting voice. He feels it is an overrated gadget as fever is a natural protective body response. Fancy digital thermometers are available with beepers or buzzers in the price range of Rs180-Rs250. The old mercury model is losing favour due to pollution and mercury poisoning risk issues.
Pavithra S. Kumar, mother of a five-year-old, recommends the ear thermometer, especially for small kids. This comes equipped with a memory that can store five to six previous readings, making it easy to monitor the fever. However, neighbourhood chemists rarely stock this and most of the people we spoke to had bought the gadget on trips abroad or had visiting relatives bring it for them. It is available online on eBay India for Rs3,750.
Blood pressure monitoring kits
These come in fully automatic and semi-automatic variants. There are also options where the cuff is wrapped either around your arm or wrist. Both are fairly simple to use and care should be taken to place the cuff at the same level as your heart.
Dr Roy says that given the stress levels of most young Indians today, this is a kit worth investing in, though professional opinion is divided on which one is the best. What makes the kit specially useful is that high blood pressure or hypertension is often symptom less, so detecting it early is important. Prices differ from model to model, with the digital wrist cuff model being priced at around Rs4,000.
With an estimated 35-40 million diabetics in India, it’s not surprising that the country is flooded with blood sugar monitoring devices of various hues. There has been a dramatic dip in prices as well as technological leaps as far as new models are concerned, providing you with a seven-14-day average. A kit that cost over Rs4,000 a couple of years ago today retails for around Rs1,500.
Typically, the glucometer comes with a lancing device and 10-25 sensor strips. To test blood sugar, prick your finger with the lancing device, smear some blood on the sensor strip and insert it into the glucometer. Strips can be easily replaced.
Doctors recommend this device only for those already diagnosed with a diabetic condition. Dr Aggarwal also suggests that diabetics invest in urine reagent strips to test urine sugar at home.
Pregnancy tests
These are, perhaps, the oldest DIY kits available, fairly inexpensive, and the test is simple enough to be carried out at home. Available at most chemists, these retail for around Rs45-50 a pack (containing four or five strips.)
There are a few sophisticated newer versions available where the strips can be held directly against the urine stream, eliminating the need to collect urine in a container. These types are slightly more expensive.
Ovulation predictor
For those trying hard to get the stork to visit their home, an ovulation predictor is a good investment. Says Dr Malpani: “Ovulation predictor tests are very useful and extremely underrated in India.”
He describes how there is a growing number of “worried well” in India, who come to his infertility clinic, stressed out because everyone else is having a baby. For such couples, he recommends the ovulation predictor which indicates a woman’s most “fertile” time. Available at some of the bigger chemists and at IVF clinics, these cost around Rs1,500.
Peak flow meter
Asthma is estimated to affect five-10% of the population in India and its prevalence is growing by the day, especially among schoolchildren.
Studies have linked the dramatic decline in emergency hospital admissions of asthmatics in the UK to the use of peak flow meters (about four to five lakh units are sold in the UK annually).
Surprisingly, in India, this device hasn’t been used to its potential, although at around Rs500 or so, this portable, hand-held device that can give an early warning signal of an imminent attack is relatively inexpensive.
The peak flow meter, which can be used on anyone over age six, measures your ability to push air out of your lungs. Any change in measurement from the normal can signal trouble, hours before symptoms are felt. Doctors recommend the daily usage of a peak flow meter by asthmatics, who should record morning and evening peak flow reading.
Reviewing this record gives the doctor valuable information about the effectiveness of the drug therapy. Several models are available, but those who use the device recommend those in which the mouthpiece is in a straight vertical line rather than angled.
Some high-end models also come with software and a USB cable so that you can download readings on your computer.
Eye test charts
An eye test chart—the kind that you see hanging at the ophthalmologist’s—is useful to have around the house, especially if you have kids.
You can download colour blindness tests from the Internet. If there are older people at home, you could also download the Amsler Grid—if the lines on this grid appear wavy, then it signals the onset of macular degeneration. These are simple checks you can do at home to get early warnings.
Dr Umang Mathur of Dr Shroff’s Charity Eye Hospital in Delhi says that they cannot be a substitute for regular, scheduled eye check-ups. Conditions like glaucoma cannot be detected by home tests. Tests every year are recommended for growing children. For adults, an eye test is a must at the age of 40.
The doctor’s just a click away
“I always say that the first thing a person should do is visit the Internet and then the doctor,” says Dr Aniruddha Malpani.
Although the other doctors we spoke to did not share Dr Malpani’s enthusiasm, they did admit that the Internet is emerging as a valuable resource of health-diagnosis tools.
Of course, a person has to be very careful about ascertaining the reliability of the sites.
On the Net, there are some excellent tests for conditions like Repetitive Strain Injury (RSI). For instance, Desk Doctor (www.einspine.com) helps you detect and prevent RSI and even rehabilitate sufferers.
There is other RSI-related software which you can download on your desktop, and which pops up and reminds you that it is time for you to take a break or do neck exercises.
Dr Dipanjan Roy recommends downloading and taking prints of wallet-sized symptom cards.
In many countries abroad, symptom cards—which are also retailed as fridge magnets—are available for a range of diseases like meningitis, ovarian cancer, cardiac problems and so on.
These cards list out the symptoms of various ailments, thereby reminding you that a visit to the doctor is due.
(Write to us at businessoflife@livemint.com)
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First Published: Tue, Mar 13 2007. 12 16 AM IST
More Topics: Business of Life | Health |