Sue Austin: Deep sea diving … in a wheelchair

When Sue Austin got a power chair 16 years ago, she felt a tremendous sense of freedom — yet others looked at her as though she had lost something. In her art, she aims to convey the spirit of wonder she feels wheeling through the world. Includes thrilling footage of an underwater wheelchair that lets her explore ocean beds, drifting through schools of fish, floating free in 360 degrees. (Filmed at TEDxWomen.)

In repurposing her wheelchair to create fantastical art, Sue Austin reshapes how we think about disability.

Osteoarthritis

osteoarthritis-262x174What is Osteoarthritis ?

Osteoarthritis (OA) also known as degenerative arthritis or degenerative joint disease or osteoarthrosis, is an age related disease caused by the aging and wear and tear on a joint. Basically, the cartilages, the tough and flexible connective tissue covering ends of bone joints that cushion the bones, become less resilient leading to painful and swollen joints. While osteoarthritis can damage any joint in your body, the disorder most commonly affects weight-bearing joints in your hands, neck, lower back, knees and hips.

What causes Osteoarthritis ?
A variety of causes— age, obesity, extreme physical work, injuries —may initiate processes leading to loss of cartilage. When bone surfaces become less well protected by cartilage, bone may be exposed and damaged. As a result of decreased movement secondary to pain, regional muscles may atrophy, and ligaments may become more lax.

Osteoarthritis in India
In India, Osteoarthritis affects over 15 Million people each year, most in the 65+ age group, though of late there have been more cases identified in the age group 35 – 55 years. According to the World Health Organization, this year over 30% of the people over the age of 65 in India are likely to suffer from severe osteoarthritis.

 

 

Types of pain and palliative care

Pain is defined as an unpleasant sensation both physically and emotionally.

woman-lower-back-pain-lgnPain that is from the organs is called visceral pain. It is pain that results from the activation of nociceptors of the thoracic, pelvic, or abdominal viscera (organs). Visceral structures are highly sensitive to distension (stretch), ischemia and inflammation, but relatively insensitive to other stimuli that normally evoke pain such as cutting or burning. Visceral pain is diffuse, difficult to localize and often referred to a distant, usually superficial, structure. It may be accompanied by symptoms such as nausea, vomit, changes in vital signs as well as emotional manifestations.

All other pain is termed somatic in nature.  Somatic pain is also a type of nociceptive pain.  However, unlike visceral pain, the nerves that detect somatic pain are located in the skin and deep tissues. These specialized nerves, called nociceptors, pick up sensations related to temperature, vibration and swelling in the skin, joints and muscles.

If you cut your skin, the pain you experience is somatic pain. You also experience somatic pain if you stretch a muscle too far or exercise for a long period of time. Nociceptors send impulses to the brain when they detect some kind of tissue damage.

Pain can also be classified as acute and chronic.

Acute pain begins suddenly and is usually sharp in quality. It serves as a warning of disease or a threat to the body. Acute pain might be caused by many events or circumstances, including:

  • Surgery
  • Broken bones
  • Dental work
  • Burns or cuts
  • Labor and childbirth

Acute pain might be mild and last just a moment, or it might be severe and last for weeks or months. In most cases, acute pain does not last longer than six months, and it disappears when the underlying cause of pain has been treated or has healed. Unrelieved acute pain, however, might lead to chronic pain.

Continuous pain is called chronic pain and presents as prolonged pain and  afflicts elders and people who suffer from chronic ailments like Arthritis, renal disease, liver disease, immune disorders, musculo-skeletal diseases, neurological conditions, diabetic neuropathy etc.  Physical effects include tense muscles, limited mobility, a lack of energy, and changes in appetite. Emotional effects include depression, anger, anxiety, and fear of re-injury. Such a fear might hinder a person’s ability to return to normal work or leisure activities.

Chronic pain can persist despite the fact that the injury has healed. Pain signals can remain active in the nervous system for weeks, months, or years.

Complete pain relief  can be attained only when the underlying physiological problem is treated and the psychological aspects associated with the pain are addressed.

Palliative Care gives pain relief to patients with advanced and beyond cure diseases like cancer. It’s a medical approach that gives holistic care and is aimed at  providing total relief.

Freedom from pain is basic human right.

 

 

Safety rules when taking medicines

Prescription Medication Spilling From an Open Medicine BottleAs we grow older, for most of us the number of medicines  we take each day seems to increase steadily.  Age related diseases such as blood pressure, diabetes, heart ailments all require multiple tablets to keep in check.  Follow the rules given below to ensure that you take the right medication at the right time.  Remember, the medicines you are taking are probably life-saving drugs and it is important that you are diligent in following all the instructions given by the doctor and those written on the labels.

 

Do’s

  1. Read the label carefully.
  2. Check that the medicine is not older than the use by date. Expired drugs may not be as effective.
  3. Find out what the medicine is for and why it has been prescribed for you.
  4. Understand and follow the dosage, direction and timing directives properly.
  5. Always inform the doctor about all the other medications you are taking.
  6. Read the contra-indications carefully and look out for the side-effects whenever you start on a new medicine.
  7. Complete the whole course prescribed by the doctor.
  8. If you miss a dose, take it immediately. If you remember only at the time of the next dose, do not double dose.
  9. Start any new medicine course during the day time, if possible.
  10. Store your medicine in a cool, dry place away from direct sunlight. Make sure that those medicines that need to be refrigerated are always stored in the refrigerator.
  11. Always ensure that the medicine you buy is of the prescribed strength. There is a world of difference between 25mg and say, 50mg or 100mg.
  12. Use a pill box with day-of-week slots to sort and store medicine to be taken each week.

Don’ts

  1. Do not take your medication in the dark.
  2. Do not powder pills unless the doctor has recommended it. Some tablets are meant to be slow release tablets and powdering them may speed up absorption and lead to unwanted complications.
  3. Do not share medicines with other.
  4. Do not take the first dose of any new medication in the night if you can avoid it.
  5. If the pharmacist does not have the medicine prescribed by the doctor, ask the doctor for an alternative drug. Do not go by the pharmacist’s recommendation.

Beware of the yield claims on tax-saving products

It’s the tax-saving season and one of the popular tax-saving instruments – the five-year tax-saving bank deposit – is being promoted by banks. A major public sector bank has been prominently advertising its five-year tax-saving deposit, stating yields of 16.64 per cent pre-tax, for regular investors and 17.39 per cent for senior citizens. The rates of interest on these are 8.5 per cent and 9 per cent respectively.

The pre-tax magic

How can an 8.5-percent-a-year interest-generating deposit deliver almost twice the return? Are their claims valid?
Well, they are; only it does not give the full picture. The said advertisement bumps up your returns by considering the tax you save but totally ignores the tax that your interest income will suffer. In other words, it considers the benefit and stops there at a pre-tax stage to make the returns attractive.

Let us take an example to see how this is done: If you invest Rs 10,000 in a five-year deposit that returns 8.5 per cent a year (compounded quarterly) then you will have Rs 15,228 at the end of five years. But remember, in the first year you save taxes to the extent of Rs 3,090 (30% of Rs 10,000 plus 3% cess), if you are in the 30% tax bracket. Therefore your net cash outflow in the year of investment is taken to be Rs 6,910 (10,000-3090).

Lower returns post tax

The effective pre-tax yield is therefore about 17.1 per cent {(15,228/6910)^1/5}. But did you know that the interest of Rs 5228 suffers income tax? Interest income from deposits are treated as ‘income from other sources’ and taxed. So if you are in the 30% tax bracket, you will have a tax burden of Rs 1615, including 3% cess. Net of this, your maturity value is only Rs 13,613 (Rs 15,228-1,615). So the yield comes down to 14.5 per cent.

The return comes down if you are in the lower tax bracket of 10 per cent. Why? Because you enjoy only Rs 1,030 (10% of Rs 10,000 plus cess) as tax saved, instead of Rs 3,090. See table below to know, the actual post tax yields for those in the 10%, 20% and 30% tax bracket.

deposit yield

And remember, if you are a senior citizen, you may well be in the lower tax bracket, which means that your benefits post tax are definitely much lower than what the advertisement claims; although you may receive a slightly higher rate of interest.

Hence, you would do well to take the claims of ‘high yield’ advertisements with a pinch of salt.

The humble NSC

That said, are there any other debt options with similar maturity at this juncture that would provide tax-saving under Section 80C and also deliver good yields post tax? As seen in the table below, both regular investors and senior citizens can earn superior post tax yield if they invest in NSC. This is because, the interest on NSC, although taxable, is treated as reinvested every year under Section 80C and is therefore allowed as deduction. As a result, only the last year’s interest is actually taxed.

nsc yield

In contrast, interest on a bank tax-saving deposit is taxed entirely.

Hence, if you are a tax payer and can take a five-year lock-in, NSC’s current rate (applicable only up to March 2013) is attractive from a post tax perspective.

This article was written by Ms. Vidya Bala, a member of the financial advisory committee at Old is Gold Store.

Diabetic Retinopathy

retinopathyDiabetes is an emerging global health problem today, with India all set to take on the dubious mantle of “The Diabetic Capital Of The World” due to its huge volume of diabetic patients. Diabetes affects all parts of the body, most importantly the eye. In recent years, the prevalence of diabetic eye disease has been increasing at an alarming rate.  Let us address several questions on this burning health problem to get more awareness.

a.)What is diabetic retinopathy?

Diabetic retinopathy is the most common diabetic eye disease and a leading cause of blindness in the middle-aged population. It is the affection of the retina (the light sensitive layer of our eyes) due to diabetes. If untreated, it  can cause severe vision loss or even blindness. It usually affects both eyes.

b.)What are the symptoms and signs of diabetic retinopathy?
Often there are no symptoms in the early stages of the disease, nor is there any pain. Don’t wait for symptoms. Be sure to have a comprehensive dilated eye exam at least once a year.

Diabetic retinopathy has four stages:

  1. Mild Nonproliferative Diabetic Retinopathy. At this earliest stage, there are small areas of balloon-like swelling in the retina’s tiny blood vessels called microaneurysms.
  2. Moderate Nonproliferative Diabetic Retinopathy. As the disease progresses, some blood vessels that nourish the retina are blocked.
  3. Severe Nonproliferative Diabetic Retinopathy. Many more blood vessels are blocked, depriving several areas of the retina of their blood supply.
  4. Proliferative Diabetic Retinopathy. At this advanced stage, signals are sent by the retina for more nourishment, which trigger the growth of abnormal and fragile new blood vessels. These leak blood causing spots or floaters. This is called vitreous hemorrhage (bleeding in the vitreous: the gel-like substance that fills the center of the eye).

At any of the above stages, fluid can leak into the macula, (the central part of the retina responsible for your vision) causing blurring of vision. This condition is called macular edema.

c.) What is the treatment of Diabetic Retinopathy?

If your eye care professional believes you need treatment for macular edema, he or she may suggest a fluorescein angiogram. In this test, a special dye is injected into your arm. Pictures are taken as the dye passes through the blood vessels in your retina. This helps in planning treatment.

Laser treatment either in the form of pan retinal photocoagulation (PRP) or focal  is usually the treatment of choice for vision threatening diabetic retinopathy. Once you have proliferative retinopathy, you always will be at risk for new bleeding. You may need treatment more than once to protect your sight.

Vitrectomy is another surgery commonly needed for diabetic patients who suffer vitreous hemorrhage, in which the vitreoretinal surgeon carefully removes blood and vitreous from the eye, and replaces it with clear salt solution (saline). It is important to always remember that although these treatments have high success rates, they do not cure diabetic retinopathy.

d.)What is the bottom line?

Better control of blood sugar levels, regular retinal evaluations, early detection and timely treatment can prevent vision loss due to Diabetic Retinopathy.

This article is written by Dr.Vasumathy Vedantham MS, DNB,FRCS,  Medical Director & Consultant Vitreoretinal Surgeon at Radhatri Nethralaya.

IIT-M students working on advanced wheelchair

Two students of the Indian Institute of Technology, Madras (IIT-M) have developed a wheelchair prototype that allows users to sit, stand and recline too.

The wheelchair, which allows users to manually operate it, has controls for the sitting, standing and reclining functions. It has been designed to allow users to operate it easily. To ensure the user does not fall down when she attempts to lean forward, the device has a provision to strap in the user across the trunk and legs.

You can read more about it here.

Senior Heroes – Ingvar Kamprad

ingvar_kampradI read an article recently about the founder of IKEA and the world’s 8th richest man estimated to be worth 15.7 Billion GBP. One incident stood out!  Below I am quoting the article

Recently, a statue of him was erected in his Swedish home town, and he was invited to cut the ribbon. It was reported that instead he untied it, folded it neatly and handed it to the mayor, telling him he could now use it again.

While we may think that he is tight-fisted, another way to look at it is how the previous generation lived while keeping their carbon footprint (even though the term was not even invented then!) low.

Read more: http://www.dailymail.co.uk/news/article-559487/He-lives-bungalow-flies-easyJet-dries-times-year–man-founded-Ikea-worth-pound-15bn.html#ixzz2LJkORsLc

Choosing the right walking aid

As you age, it is not uncommon to have balance problems. Reasons could be as diverse as heel pain to dizzy spells. Once you have gone to the doctor and ensured that the underlying problem is being taken care, it may be a good idea to get your self a walking aid so as to avoid falls.

The simplest aid is a cane. They come in various materials from wood to plastic to metal, with different grips. You hold them in your stronger hand and use it to put some weight on them when you walk.

The next option is a tripod. It is similar to a regular cane, but has 3 legs at the bottom. The wider base affords you greater stability.

Another similar option is a quad cane or a quadripod. This is similar to a tripod, but has 4 legs at the bottom. All these canes are usually height adjustable except the wooden ones.

If your balance problem is severe, the other alternative is to use a walker. A walker is a four-legged contraption that provides you much greater stability. Within walkers you have static walkers, recriprocal walkers and reciprocal walkers with wheels. The static walker requires you to lift it and move forward each time, while the reciprocal walkers allow you to slide them forward, one side at a time. These afford the best support for people who find walking unaided difficult.

To check out all the mobility aids, go here.

If you have balance issues, keep an appropriate walking aid handy. Its much better to have a walking aid with you than to have a fall and break some bones!

Liquids funds – A supplement to your savings bank account

liquidfundsHave you been idling large sums in your savings bank account just to provide for any unforeseen need? If so, you could still have managed 5-6 percentage points more by setting aside at least a part of your money in liquid funds and still have liquidity.

Yes, liquid funds, offered by mutual fund houses invest in short-term money market instruments such as government securities, treasury bills and commercial paper. In a way, they park your money in instruments not too different from the way banks do and hence are reasonably secure. And yet, their returns, as the table below suggests, have been far superior to savings bank rate. Although saving bank rates have been deregulated by the RBI, only couple of banks offer 6% to 7%. The rest give you only 4% currently.

superiorreturns

Features of liquid funds

  • Invest in short-term government securities and certificate of deposits, making them reasonably secure
  • Provide flexibility to invest or withdraw any time without any exit load or penalty.
  • Some mutual fund houses even offer an ATM card to withdraw the funds
  • Tax efficient schemes
  • Have historically provided higher returns than savings bank interest rate

When to use

  • To create an emergency fund which can be withdrawn any time
  • To temporarily park any lump sum you may have received
  • To save for short-term goals such as saving for an impending vacation
  • To park money and systematically invest in other high yielding schemes such as equity funds

How to plan

Segregate the money in your savings account into two: one, the sum that you need for your day-to-day operational cash flows and the rest for contingencies or for a short-term goal. Let the first part remain in your savings account as you need this for your daily expenditure. Shift the rest to a liquid fund. If you have a time frame of over 3 months then you can consider ultra-short-term funds as well. This can give you slightly higher returns than liquid funds.

Being tax efficient

Did you know that you need to pay tax on the interest that your savings account balance fetches? Yes, such interest income is taxed at the tax slab in which you fall – 10%, 20% or 30%. Liquid funds too, are taxed (as capital gains) in the same rate if held for less than one year (indexation benefits are available for holdings greater than one year).

But you can plan to reduce the impact of capital gains tax n liquid funds. Here’s how: if you are in the high tax bracket of 30% opt for dividend payout or daily dividend reinvestment. This will reduce or nullify your capital gains. If you are in the lower tax bracket, you can instead take the growth option since the tax rate is anyway low.

Corporate houses have been using liquid funds to park their daily surpluses and derive some returns. As retail investors, you can take also benefit from these schemes.

Birla Sun Life Floating Rate Short Term Plan, Peerless Liquid and HDFC Cash Management Savings Plan are some of the liquid funds that you can consider.

This article was written by Ms. Vidya Bala, a member of the financial advisory committee at Old is Gold Store.